Sleep Apnea Linked to Diabetic Retinopathy

Severe sleep apnea has been linked to the development of macular edema in diabetic patients, as per the findings of a new study from Taiwan. Diabetic macular edema, which can cause visual impairment and even blindness, is more difficult to treat in patients suffering from severe sleep apnea. This new study clearly indicates that sleep apnea exacerbates underlying eye conditions.

The research, led by Dr. Juifan Chiang, MD from the Chang Gung Memorial Hospital in Taiwan, was presented at ‘AAO 2019’, the Annual Meeting of the American Academy of Ophthalmology (AAO) held on 12-15 October, 2019 in San Francisco, USA.

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How is Sleep Apnea Linked to Damage to the Retina?

Sleep apnea is a sleeping disorder characterized by interrupted breathing at regular intervals, resulting in disruption of sleep and a drop in oxygen levels in the blood. This drastic fall in blood oxygen levels can lead to injury to blood vessels, especially, small capillaries such as those supplying the retina, which is the light-sensitive tissue layer at the back of the eye.

In the case of diabetic patients, this damage is exacerbated, leading to fluid build-up or edema in the macula, which is the central portion of the retina responsible for sharp, clear and distinct vision. The macula swells and thickens as a result of fluid build-up (macular edema), which can cause distortion of vision and in severe cases, even blindness. This condition is known as diabetic retinopathy.

In people suffering from sleep apnea, diabetic retinopathy progressively worsens due to increased insulin resistance, excessive inflammation, and elevated blood pressure, all of which collectively damage the retinal blood vessels.

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Key Findings of the Study

• The study was conducted on diabetic retinopathy patients over an 8-year period
• Sleep apnea was higher in patients with diabetic macular edema than those without (80.6% vs. 45.5%)
• Severity of sleep apnea was positively correlated with the severity of diabetic macular edema
• Severe sleep apnea was more prevalent in patients requiring additional treatments for diabetic macular edema
• Patients with severe diabetic macular edema required three or more additional laser therapy sessions

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Concluding Remarks

“Based on these results, we hope that more medical professionals will approach sleep apnea as a risk factor for diabetic macular edema,” said Chiang. “This could allow for earlier medical intervention so patients can keep more of their vision and preserve their overall health as much as possible.”

Reference:

1. ‘AAO 2019’: American Academy of Ophthalmology Annual Meeting 2019, San Francisco, USA - (https://www.aao.org/annual-meeting)

Source-Medindia