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The relationship between increased oxidative stress and visual field defect progression in glaucoma patients with sleep apnoea syndrome
Author(s) -
Yamada Erika,
Himori Noriko,
Kunikata Hiroshi,
Omodaka Kazuko,
Ogawa Hiromasa,
Ichinose Masakazu,
Nakazawa Toru
Publication year - 2018
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/aos.13693
Subject(s) - medicine , glaucoma , visual field , oxidative stress , ophthalmology , logistic regression , odds ratio , intraocular pressure
Abstract Purpose Sleep apnoea syndrome ( SAS ) is often associated with glaucoma, and intermittent hypoxia, present in SAS , can contribute to glaucoma pathogenesis. However, the relationships between SAS , high systemic oxidative stress and the speed of glaucoma progression are unclear. Thus, we investigated these relationships in glaucoma patients with and without SAS . Methods Peripheral blood samples were collected from 166 eyes of 166 Japanese patients: 42 controls, 109 open‐angle glaucoma ( OAG ) patients without SAS and 15 OAG patients with SAS . Prognostic factors for visual field defect progression were determined with logistic regression. Diacron reactive oxygen metabolites ( dROM ) and biological antioxidant potential ( BAP ) were measured with a free radical analyser. Clinical parameters were also recorded. Intergroup comparisons used the Mann–Whitney U test. Results Multiple regression analysis showed that SAS was a statistically significant contributing factor to fast visual field defect progression, defined as mean deviation ( MD ) slope ≤−2.0 dB /Y ( SAS : odds ratio ( OR ) = 14.48; p = 0.002). The non‐ SAS and SAS groups had similar age, sex, intraocular pressure (IOP), axial length and antiglaucoma drug use. The SAS group had a significantly higher dROM level (p = 0.001), BAP level (p = 0.038) and steeper MD slope (p = 0.001) than the non‐ SAS group. Conclusion Glaucoma patients with SAS have higher dROM , as well as steeper MD slope, than patients without SAS , suggesting that SAS may induce systemic oxidative stress and promote glaucomatous visual field defect progression.