Patients with obstructive sleep apnea (OSA) may be at an increased risk of exfoliation syndrome (XFS), especially if they have a history of hypertension, according to new research in Ophthalmology Glaucoma.

Since both XFS and OSA have been linked to glaucoma, researchers from the University of Utah and the New York Eye and Ear Infirmary of Mount Sinai analyzed the potential relationship between the two conditions. Research already shows that XFS can lead to altered elastin matrices in ocular and systemic tissues, and sleep apnea involves elastic tissue dysfunction.

The investigation included 81,735 patients between the ages of 50 and 90 who were diagnosed with OSA based on medical records from the Utah Population Database from 1996 to 2017. Case subjects were matched to random controls based on sex and birth year in a 4:1 ratio.

The researchers found a more than 20% increased risk of an XFS diagnosis in OSA patients (odds ratio of 1.27) compared with the non-OSA controls. When stratifying patients by hypertension diagnosis history, they noted that OSA patients with hypertension were 2.67 times more likely to have a diagnosis of XFS compared with non-OSA controls with hypertension.

Shumway C, Curtin K, Taylor S, et al. Association between obstructive sleep apnea and exfoliation syndrome: the Utah project on exfoliation syndrome. Ophthalmol Glaucoma. September 29, 2020. [Epub ahead of print].