Correlation between Primary Open-Angle Glaucoma and Symptoms of Obstructive Sleep Apnea Syndrome: A Case-Control Study Conducted in Abidjan

Introduction: Primary open-angle glaucoma (POAG) is a chronic progressive optic neuropathy which is a major cause of irreversible blindness worldwide. Its pathogenesis, which is still poorly understood, involves intrinsic and extrinsic factors. Most of the treatment is based on intraocular pressure, which is the main modifiable factor. Among extraocular factors, obstructive sleep apnea syndrome (OSAS) is rarely investigated in practice by ophthalmologists. Also, few studies in sub-Saharan Africa have explored the relationship between POAG and OSAS in African populations, hence the interest of this work, which aims to establish the correlation between POAG and OSAS symptoms. Patients and Method: The authors conducted a prospective cross-sectional case-control study at the Treichville University Hospital in Abidjan over a twelve-month period from January 2022 to December 2023 in a population of melanoderms adults subdivided into two subgroups, one for glaucoma patients and the other for non-glaucomatous patients, in search of signs of OSAS. Signs of OSAS were sought in all patients regardless of subgroup. Patient records were selected after written informed consent. Incomplete records and patients with defects were not included. The study took into account ethical and deontological considerations in accordance with the principles of the declaration of Helsinki. The data collected were epidemiological, anamnestic and clinical (signs of OSAS). They were collected on a survey form and analysed using Microsoft 2016 and Epi Info 7 version 1.3 software. The statistical significance threshold was α < 5%. Results: We collected 159 patients divided into two subpopulations, predominantly male (57.23%). The predominant age group was between 40 and 50 years. Clinically, snoring predominated in glaucoma patients (63.29%) compared with (36.25%) in non-glaucoma patients (p = 0.001). On the Epworth scale, excessive daytime sleepiness was more frequent in glaucoma patients than in the control population, 73.68% versus 26.32% (p = 0.001). According to the ODSI questionnaire, daytime sleepiness was higher in glaucoma patients than in non-glaucoma patients 72.22% versus 27.78% (p = 0.003). Discussion: This study revealed a higher prevalence of OSAS symptoms in patients with POAG. Signs such as snoring and daytime sleepiness were identified as being significantly associated with both pathologies. Thus, having a symptom of sleep apnea increases the risk of developing chronic glaucoma in the African melanoderm population. In addition to lowering intraocular pressure, it is important to stress the importance of screening and managing sleep apnea symptoms in all glaucoma patients.