Table 1.
Characteristics of the Included Studies for Studying the Effect of OSA on DED
| Study | Country & region | Study type | Mean age (year) | Gender (male;%) | BMI (kg/m2) | Sample size | OSA patients | Non-OSA patients (control) | Dry eye assessment tool | Treatment for OSA patients | General results (OSA patients) | Enrolled for quantitative analysisa |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Acar, 2013 29 | Turkey | Prospective cohort | 48.1 ± 10.5 | 70.4 | Non-OSA: 28.3 ± 4.7; OSA: 31.5 ± 5.9 | 280 | 254 (mild: 60; moderate: 72; severe: 122) | 26 | TBUT, Schirmer test, OSDI, CFS | - | Poorer dry eye data among OSA subgroups (all parameters) | v |
| Fox, 2017 30 | US | Cross- sectional |
53.2 ± 13.5 | 56.7 | Non-OSA: 31.0 ± 12.5; OSA: 33.0 ± 6.8 | 201 | 166 (mild: 33; moderate: 70; severe: 63) | 35 | CFS | - | No significant impact on CFS among OSA subgroups | v |
| Gunes, 2023 31 | Turkey | Cross- sectional |
47.1 ± 12.0 | 68.9 | - | 106 | 77 (mild: 23; moderate: 27; severe: 27) | 29 | TBUT, Schirmer test, OSDI | Nil | Poorer dry eye data among OSA subgroups (all parameters) | v |
| Hao, 2023 32 | China | Cross- sectional |
39.7 ± 17.8 | 66.2 | Non-OSA: 26.6 ± 2.0; OSA: 30.5 ± 4.9 | 71 | 27 (mild and moderate: 14; severe: 13) | 44 | TBUT, Schirmer test, OSDI, CFS | - | Poorer dry eye data among OSA subgroups (most parameters); no significant impact on Schirmer test | v |
| Kadyan, 2010 33 | UK | Prospective cohort | 55.6 ± 10.9 | 80.0 | Non-OSA: 32.9 ± 5.2; OSA: 35.0 ± 7.2 | 115 | 89 (all were moderate to severe) | 26 | TBUT | CPAP (67/89) | Poorer dry eye data (all parameters) | v |
| Karaca, 2016 34 | Turkey | Cohort | 47.5 ± 11.5 | 67.0 | Non-OSA: 25.9 ± 3.6; OSA: 30.4 ± 5.0 | 100 | 50 (mild: 15; moderate: 15; severe: 20) | 50 | TBUT, Schirmer test, OSDI | Nil | Poorer dry eye data (all parameters) | v |
| Lin, 2022b 35 | Taiwan | Prospective cohort | 40.9 ± 10.0 | 69.6 | Non-OSA: 23.7 ± 3.6; OSA: 26.5 ± 3.9 | 181 | 155 (mild: 53; moderate: 42; severe: 60) | 26 | TBUT, Schirmer test, OSDI, CFS | Nil | Poorer dry eye data among OSA subgroups (TBUT); no significant impact on Schirmer test, OSDI, and CFS | v |
| Muhafiz, 2020 36 | Turkey | Prospective cohort | 46.3 ± 10.8 | - | - | 59 | 32 (mild: 9; moderate: 6; severe: 17) | 27 | TBUT, Schirmer test | Nil | Poorer TBUT in OSA patients; no significant impact on Schirmer test | v |
| Pu, 2022 37 | China | Case- control |
53.9 ± 13.0 | 61.6 | Non-OSA: 26.6 ± 4.9; OSA: 30.4 ± 5.5 | 250 | 125 (mild: 32; moderate: 54; severe: 39) | 125 | TBUT, Schirmer test, OSDI, CFS | - | Poorer dry eye data among OSA subgroups (all parameters) | v |
| Karaca, 2019 38 | Turkey | Cross- sectional |
49.6 ± 9.3 | 82.0 | Mixeda | 60 | Mixeda (simple snoring and mild: 24; severe: 36) | TBUT, Schirmer test, OSDI, CFS | Nil | Severe-OSA patients had significantly poorer TBUT only when compared to mild- and non-OSA patients; no significant difference in the rest of the parameters | - | |
| Liu, 2022 39 | China | Cohort | 38.9 ± 8.8 | 93.2 | 27.2 ± 3.1 | 103 | 103 (mild: 21; moderate: 20; severe: 62) | - | TBUT, Schirmer test, OSDI, CFS | Nil | Severe-OSA patients had the poorest TBUT, Schirmer test, and CFS; no significant impact on OSDI | - |
Notes: aFor studies not suitable for quantitative analysis despite meeting the whole selection criteria, one study (Liu et al, 2022) is due to lack of a control group for further comparison; one study (Karaca et al, 2019) is due to unextractable statistical data for synthesis. bOriginal data obtained from author.
Abbreviations: OSA, obstructive sleep apnea; DED, dry eye disease; TBUT, tear breakup time; OSDI, ocular surface disease index; CFS, corneal fluorescence-staining score (Oxford grading system); CPAP, continuous positive airway pressure.