CPAP Therapy Raises Intraocular Pressure, Study Cautions Glaucoma risk

Results

Intraocular Pressure (IOP):

• The pooled mean IOP following CPAP therapy did not differ significantly from the baseline values (MD: 0.58 mmHg, 95% CI: -0.33 to 1.19).

• A subgroup analysis demonstrated a significantly higher IOP following in-lab positive airway pressure titration (MD: 4.28 mmHg, 95% CI: 0.91 to 7.66) and after long-term CPAP use (MD: 0.45 mmHg, 95% CI: 0.07 to 0.83).

Ocular Perfusion Pressure (OPP):

• OP under CPAP decreased considerably (MD: -2.15 mmHg, 95% CI: -3.50 to -0.80).

 Retinal and Macular Thickness:

• Retinal nerve fiber layer thickness and macular layer thickness were not significant in pooled data.

Long-term CPAP therapy in OSA patients was associated with a significant increase in intraocular pressure and decrease in ocular perfusion pressure without affecting other ophthalmologic parameters. These results indicate that caution is necessary when using CPAP therapy in patients with glaucoma or at risk for increased IOP. Complete ophthalmologic assessment and monitoring should be an integral part of the management of such patients.

Reference:

Kongchan P, Banhiran W, Chirapapaisan N, Kasemsuk N. The effect of continuous positive airway pressure therapy on intraocular pressure in patients with OSA: a systematic review and meta-analysis. J Clin Sleep Med. 2025 Jan 16. doi: 10.5664/jcsm.11552. Epub ahead of print. PMID: 39815722.