EW NEWS & OPINION
October 2017
29
Editors' note: Drs. Tahrani, Ni, and
Mendelson have no financial interests
related to their comments.
Surgeons and Consultants, Holly-
wood, Florida. "Weight loss, en-
hanced diabetic control, improve-
ment in the metabolic disturbances,
and well-controlled blood pressure
have all slowed or eliminated
progression of retinopathy and
simultaneously reduced the risk of
other systemic microvascular com-
plications of diabetes. In essence,
all individuals with OSA should be
monitored vigilantly by their pulm-
onologist, endocrinologist, cardiolo-
gist, and ophthalmologist."
"It is also important to recog-
nize that patients with DR are at in-
creased risk of having OSA and that
having OSA will increase the risk of
progression to advanced DR," Dr.
Tahrani said. "Hence, it is important
to have a low threshold for assess-
ing the possibility of OSA in these
patients. Performing sleep studies,
via the appropriate specialists, would
be ideal, but even simple questions
related to OSA symptoms, such
as snoring, witnessed apneas, and
the presence of excessive daytime
sleepiness, will aid ophthalmologists
in making decisions regarding the
need for further investigations for
OSA. There are also several available
validated questionnaires that can
be used to assess the OSA risk in
patients before doing sleep studies.
"Finally, while we still do not
know for sure whether OSA treat-
ment can reduce the risk of progres-
sion to advanced DR, it is important
to recognize that OSA treatment will
have an impact on other important
aspects, including improvements in
OSA-related symptoms, lowering the
blood pressure, lowering the risk of
road traffic accidents, and improving
the patient's quality of life." EW
References
1. Altaf QA, et al. Obstructive sleep apnoea
and retinopathy in patients with type 2 diabe-
tes: A longitudinal study. Am J Respir Crit Care
Med. 2017 June 8. Epub ahead of print.
2. McNab AA. Floppy eyelid syndrome and ob-
structive sleep apnea. Ophthal Plast Reconstr
Surg. 1997;13:98–114.
3. Purvin VA, et al. Papilledema and obstruc-
tive sleep apnea syndrome. Arch Ophthalmol.
2000;118:1626–30.
4. Chaitanya A, et al. Glaucoma and its associ-
ation with obstructive sleep apnea: A narrative
review. Oman J Ophthalmol. 2016;9:125–34.
5. Archer EL, et al. Obstructive sleep apnea
and nonarteritic anterior ischemic optic
neuropathy: Evidence for an association.
J Clin Sleep Med. 2013;9:613–18.
Contact information
Mendelson: karensuedennis@gmail.com
Ni: michael.gedmin@advicemedia.com
Tahrani: A.A.Tahrani@bham.ac.uk
