EVALUATION OF OBSTRUCTIVE SLEEP APNEA SYNDROME AS A RISK FACTOR FOR DIABETIC MACULAR EDEMA IN PATIENTS WITH TYPE II DIABETES

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Abstract

Purpose:

To evaluate the association between obstructive sleep apnea and diabetic macular edema (DME) in patients with Type II diabetes, using the apnea–hypopnea index and other nocturnal hypoxemia parameters.

Methods:

This cross-sectional, case–control study included 99 patients with Type II diabetes: the first group included patients with DME (DME+ group) and the second patients without DME (DME− group). Polysomnography was performed in all patients. The two groups were compared, and the risk factors were studied using logistic regression.

Results:

The DME+ group comprised 38 patients, and the DME− group comprised 61 patients, aged a mean 68.8 years and 66.3 years (P = 0.27), respectively; mean body mass index was 29.7 and 30.9 (P = 0.16), respectively. The mean apnea–hypopnea index was significantly higher in the DME+ group (43.95 [13.5–87.3]) than in the DME− group (35.18 [3.55–90.7]) (P = 0.034). Patients with DME had more severe obstructive sleep apnea (apnea–hypopnea index >30) than the others: 71% versus 50.8% (P = 0.049). Cumulative time of SPO2 below 90% (CT90%) was independently associated with DME after adjusting for confounding factors, whereas there was no difference between the oxygen desaturation index and minimum O2 saturation.

Conclusion:

Severe obstructive sleep apnea (apnea–hypopnea index >30) and parameters of nocturnal hypoxemia (cumulative time of SPO2 below 90%) are associated with DME.

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