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Obstructive sleep apnea, retinopathy linked in diabetes
May 20, 2009The eyes may be the window into the soul, but they may also contain important medical information. According to new research to be presented at the American Thoracic Society's 105th International Conference in San Diego on May 19, patients with diabetes who have retinopathy should also be screened for obstructive sleep apnea (OSA).
"We know from our earlier research that 23 percent of men with type 2 diabetes have OSA and this is under-recognized and under-treated," said Sophie D. West, M.D., of the Oxford Centre for Respiratory Medicine in the United Kingdom, who led the research. "This study suggests that OSA is linked to retinopathy in type 2 diabetes."
The researchers analyzed data from 118 men who had participated in the earlier study on the prevalence of OSA in type 2 diabetes in Oxford, England, and who also had retinal images to review. (All patients with type 2 diabetes in the U.K. are offered annual retinal screening to look for signs of retinopathy.) The images were studied by ophthalmology graders for evidence of retinopathy and the sleep study data was reviewed to determine the presence or absence of OSA.
The researchers found that retinopathy was present in more than half-54 percent-of those who had OSA, compared to fewer than a third-31 percent-of those without OSA, independent of the effects of glucose control, age, body mass index, high blood pressure and the duration of the diabetes. This was statistically significant.
"These results suggest an association between OSA and retinopathy that should be further investigated," said Dr. West. "While the study only analyzed data from men, there is no reason to believe that gender would play a role in the results."
There has been very little work previously regarding the relationship between OSA and retinopathy. Previous studies have found strong links between poor glucose control and high blood pressure with retinopathy and these have been the main areas upon which treatment has been targeted in diabetes in order to prevent retinopathy from developing and to delay its progression. However, in this study, OSA had a far stronger relationship with retinopathy than did glucose control or high blood pressure.
"While there is clearly more research to be done, there is an immediate implication to consider," said Dr. West. "Our message would be for doctors and nurses who see patients with type 2 diabetes to consider whether they could have OSA and whether they should therefore be referred for a sleep study."
Symptoms of possible OSA include snoring, apneas (stopping breathing) and daytime sleepiness. "Future research will try to determine whether the treatment for OSA, that is continuous positive airway pressure (CPAP), can delay the development or progression of retinopathy, associated with diabetes."
American Thoracic Society
The researchers found that retinopathy was present in more than half-54 percent-of those who had OSA, compared to fewer than a third-31 percent-of those without OSA, independent of the effects of glucose control, age, body mass index, high blood pressure and the duration of the diabetes. This was statistically significant.
"These results suggest an association between OSA and retinopathy that should be further investigated," said Dr. West. "While the study only analyzed data from men, there is no reason to believe that gender would play a role in the results."
There has been very little work previously regarding the relationship between OSA and retinopathy. Previous studies have found strong links between poor glucose control and high blood pressure with retinopathy and these have been the main areas upon which treatment has been targeted in diabetes in order to prevent retinopathy from developing and to delay its progression. However, in this study, OSA had a far stronger relationship with retinopathy than did glucose control or high blood pressure.
"While there is clearly more research to be done, there is an immediate implication to consider," said Dr. West. "Our message would be for doctors and nurses who see patients with type 2 diabetes to consider whether they could have OSA and whether they should therefore be referred for a sleep study."
Symptoms of possible OSA include snoring, apneas (stopping breathing) and daytime sleepiness. "Future research will try to determine whether the treatment for OSA, that is continuous positive airway pressure (CPAP), can delay the development or progression of retinopathy, associated with diabetes."
American Thoracic Society
Retinopathy Current Events and Retinopathy News RSSCataract surgery helps AMD patients; steroid improves DME; online eye health forum
This month's Ophthalmology, the journal of the American Academy of Ophthalmology (Academy) reports on a national study that finds cataract surgery is likely to benefit patients with age-related macular degeneration (AMD) at all stages of the disease, on a clinical trial showing that the steroid triamcinolone may be effective in advanced diabetic macular edema (DME) patients when standard treatment fails, and on the public's use of two Academy-sponsored online eye health forums.
Clues to visual variant Alzheimer's; myopia and diabetic retinopathy risk
Two studies are of particular note in today's Scientific Program of the 2009 Joint Meeting of the American Academy of Ophthalmology (AAO) and the Pan-American Association of Ophthalmology (PAAO): a report by Swiss neuro-ophthalmic researchers about vision exam clues that should make ophthalmologists suspect an atypical variant of Alzheimer's disease; and new evidence from a Singapore National Eye Center study that diabetics who are nearsighted may be less susceptible to diabetic retinopathy.
Treating ROP in tiny preemies; better glaucoma follow-up in urban clinic
Highlights of today's Scientific Program of the 2009 American Academy of Ophthalmology (AAO) - Pan-American Association of Ophthalmology (PAAO) Joint Meeting include: John T. Flynn, MD, Columbia University School of Medicine, discussing the ever-tougher challenges Eye M.D.s face in caring for the vision of the tiniest premature babies; and a report by Bradford W. Lee, MD, Stanford University School of Medicine, on barriers to glaucoma follow-up as perceived by patients in an urban, culturally diverse clinic.
First in New York: Bionic technology aims to give sight to woman blinded beginning at age 13
A 50-year-old New York woman who was diagnosed with a progressive blinding disease at age 13 was implanted with an experimental electronic eye implant that has partially restored her vision.
More infants surviving pre-term births results in higher rates of eye problems
As more extremely pre-term infants survive in Sweden, an increasing number of babies are experiencing vision problems caused by abnormalities involving the retina.
New device finds early signs of eye disease in preemies
Tell-tale signs of a condition that can blind premature babies are being seen for the first time using a new handheld device in a study at Duke University Medical Center.
Rare genetic disease successfully reversed using stem cell transplantation
A recent study by Scripps Research Institute scientists offers good news for families of children afflicted with the rare genetic disorder, cystinosis.
Elevated arginase levels contribute to vascular eye disease such as diabetic retinopathy
Elevated levels of the enzyme arginase contribute to vascular eye damage and Medical College of Georgia researchers say therapies to normalize its levels could halt progression of potentially blinding diseases such as diabetic retinopathy.
Anti-growth factor drugs raise hope and concern for treatment of children's eye diseases
A new class of antibody drugs may provide a powerful new tool for the treatment of eye diseases in children, but specialists need to be alert for the possibility of serious side effects, according to an editorial in the August Journal of AAPOS (American Association for Pediatric Ophthalmology and Strabismus), published by Elsevier.
Natural Compound Stops Diabetic Retinopathy
Researchers at the University of Oklahoma Health Sciences Center have found a way to use a natural compound to stop one of the leading causes of blindness in the United States.
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