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Sleep apnoe and perfusion pressure
Author(s) -
KIEKENS S,
DE GROOT V
Publication year - 2014
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/j.1755-3768.2014.4223.x
Subject(s) - medicine , glaucoma , continuous positive airway pressure , intraocular pressure , population , obstructive sleep apnea , perfusion , sleep apnea , blood pressure , cardiology , hypoxia (environmental) , anesthesia , apnea , ophthalmology , chemistry , environmental health , organic chemistry , oxygen
Glaucomatous disease may progress despite adequate intra ocular pressure (IOP) control. Large population based studies have shown that low ocular perfusion pressure (OPP) is a risk factor for glaucoma prevalence, incidence and progression. OPP can be calculated as the difference between arterial pressure and IOP. Obstructive sleep apnea (OSA) is a systemic condition associated with many eye conditions such as glaucoma. Its systemic implications are modifiable with Continuous positive airway pressure therapy (CPAP). In a population of OSA patients the increase in overnight IOP raise was significantly higher during CPAP therapy. The accompanied dip in nocturnal blood pressure results in a decreased ocular perfusion pressure. Moreover the auto regulatory mechanisms that need to compensate for perfusion pressure changes are affected in OSA by metabolic stresses, hypoxia and hypercapnea. Thus a higher glaucoma prevalence in OSA can be explained by the combination of an increased overnight IOP, decreased OPP and abnormal auto regulatory mechanisms that make the optic nerve more vulnerable for ischemic events.