Table 1. The 23 observational studies investigating associations between obstructive sleep apnea and glaucoma.
| No. | Reference | Nationality& Region | Participants | Mean Age(years)Case/control | Types of Glaucoma | Glaucoma diagnosis | OSAS diagnosis | Glaucoma in OSAS | Glaucoma in control | OSAS in Glaucoma | OSAS in control | Significant Association? | Adjustment for covariates | Scoring | Exclusion reason |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Included cohort Studies | |||||||||||||||
| 1 | [14] | Taiwan | Clinical Database | 66.7/67.2 | OAG | Database record | Database PSG record | 114/1012 | 410/6072 | YES | Age, sex, urbanization level, year of index date, hypertension, diabetes, coronary heart disease, hyperlipidemia, obesity, renal disease, migraine, and hypothyroidism | 4 | / | ||
| Included case-control Studies | |||||||||||||||
| 2 | [15] | France | OAG patients and control | >40 | OAG | Eye examination, | Sleep questionnaire | / | / | 58/212 | 39/218 | YES | / | 3 | / |
| 3 | [24] | USA | NTG patients and control | 40–60 | NTG | Database record,ICD-9 | Sleep history, PSG | / | / | 2/37 | 1/30 | YES | / | 3 | / |
| 4 | [17] | USA | OAG patients and control | 69/69 | OAG | Database record,ICD-9 | Database record, ICD-9 | / | / | 7/667 | 32/6667 | NO | Age, diabetes, lipid metabolism disorders, hypertension, cardiovascular disease, cerebrovascular disease, arterial disease, and migraines | 4 | / |
| 5 | [18] | Australia | OAG patients and control | 71/70 | OAG | Eye examination | Oximetry monitoring, ODI >20 | / | / | 9/52 | 7/60 | NO | / | 4 | / |
| 6 | [19] | India | OAG and NTG and control | 40–60 | OAG,NTG | Eye examination | Sleep history, PSG | / | / | 4/40 | 1/40 | NO | / | 3 | / |
| 7 | [25] | Turkey | NTG patients and control | 53–78 | NTG | Eye examination | PSG, AHI≥20 | / | / | 10/24 | 3/24 | YES | / | 4 | / |
| Included cross-sectional Studies | |||||||||||||||
| 8 | [13] | Italy | Diagnosed OSA, Consecutively with control | 74.5/75 | NTG | Eye examination | PSG, AHI≥10 | 3/51 | 0/40 | / | / | YES | / | 3 | / |
| 9 | [31] | Thailand | Suspected OSAS, Consecutively | 75/54.7 | OAG,NTG | Eye examination | PSG, AHI≥10 | 6/44 | 3/42 | / | / | NO | / | 3 | / |
| 10 | [26] | China | Suspected OSAS, Consecutively | 67.7/72 | OAG,NTG | Eye examination | PSG, AHI>5 | 4/31 | 0/25 | / | / | YES | / | 2 | / |
| 11 | [20] | UK | Suspected OSA, Consecutively | 84.3/65.4 | OAG,NTG | Eye examination | PSG, ODI≥5 | 3/89 | 1/26 | / | / | NO | / | 3 | / |
| 12 | [27] | Taiwan | Suspected OSA, Consecutively | 76.7/63.1 | NTG | Eye examination | PSG, AHI≥5 | 12/209 | 0/38 | / | / | YES | / | 4 | / |
| 13 | [16] | USA | Medical database | / | Nonspecific | Database record | Database record | 228/2725 | 3410/68235 | / | / | YES | / | 3 | / |
| 14 | [28] | USA | Medical database | >40 | OAG, | Billing records | Billing records | OAG: 4557/151633; NTG:342/156308 | OAG: 50533/2030682; NTG:154330/209916555 | / | / | NO | Age, sex, race, region of residence within the US, education level, household net worth, and some medical and ocular conditions including diabetes mellitus, hypertension, obesity, cataract, diabetic retinopathy, and macular degeneration | 4 | Data of NTG were excluded because of overlapping |
| 15 | [30] | Spain | Suspected OSA, Consecutively | 79.5/72 | OAG,NTG | Eye examination | PSG, AHI≥10 | 16/202 | 0/25 | / | / | YES | / | 3 | / |
| 16 | [29] | France | Medical database | 63.25/61.82 | / | Database record | Database record | 240/6754 | 89/2826 | / | / | NO | Age, sex, height, weight, body mass index, arterial hypertension, tobacco consumption, high cholesterol levels, high triglyceride levels, and thyroid dysfunction. | 4 | / |
| Excluded Studies | |||||||||||||||
| 17 | [32] | Switzerland | Diagnosed Glaucoma patients | 39–81 | NTG | Eye examination | PSG, RDI >10 | / | / | 7/16 | / | YES | / | / | No effective control |
| 18 | [33] | France | Diagnosed Glaucoma patients | 57.85 | OAG NTG | Eye examination | Sleep history, PSG | / | / | 15/31 | / | YES | / | / | No effective control |
| 19 | [34] | Switzerland | OSAS, Consecutively | 88.4 | OAG,NTG | Eye examination | PSG, RDI>10 | 5 /69 | / | / | / | YES | / | / | No effective control |
| 20 | [35] | Israel | Diagnosed OSAS, Consecutively | 83.3 | OAG | Eye examination | PSG, RDI>10 | 5/228 | / | / | / | NO | / | / | No effective control |
| 21 | [36] | Hong Kong | Diagnosed OSAS, Consecutively | 86.11/86.66 | / | Eye examination | PSG, AHI≥20 | 3/82(eyes) | 2/68(eyes) | / | / | YES | / | / | Not enough data |
| 22 | [37] | USA | Suspected OSA | 65 | OAG NTG | Eye examination | PSG, AHI>15 | 27/100 | / | / | / | YES | / | / | No effective control |
| 23 | [38] | Iran | Diagnosed OSAS | 51.77 | OAG | Eye examination | PSG, AHI>5 | 9/90 | / | / | / | YES | / | / | No effective control |
OSAS, obstructive sleep apnea syndrome; OAG, open-angle glaucoma; NTG, normal-tension glaucoma; ICD-9, International Classification of Diseases, 9th edition
PSG, polysomnography; ODI, oxygen desaturation index; AHI, apnea hypopnea index.