• Florent Aptel, Hafid Khayi, Jean-Louis Pépin, Renaud Tamisier, Patrick Levy, Jean-Paul Romanet, and Christophe Chiquet.
• Université Grenoble Alpes, Grenoble, France2Department of Ophthalmology, University Hospital, Grenoble, France3INSERM U1042, Lab Hypoxia and Physiopathology, Université Grenoble Alpes, Grenoble, France.
• JAMA Ophthalmol. 2015 Jul 1;133(7):797-804.

ImportanceThe prevalence of obstructive sleep apnea syndrome (OSAS) in patients with nonarteritic anterior ischemic optic neuropathy (NAION) and its influence on second eye involvement is not well known.ObjectiveTo evaluate the prevalence of OSAS in patients with NAION and risk factors of second eye involvement.Design, Setting, And ParticipantsIn this cohort study, we examined 118 patients with anterior ischemic optic neuropathy referred to a tertiary care center from January 1, 2003, through December 31, 2010.ExposuresPatients underwent polysomnography to detect OSAS and were prospectively followed up to assess the risk of second eye involvement.Main Outcomes And MeasuresThe prevalence of OSAS in patients with NAION and the risk of second eye involvement using survival analysis based on the presence of OSAS, indication for ventilation treatment with continuous positive airway pressure, and other potential ocular and systemic confounders.ResultsIn 89 patients with NAION who underwent polysomnography, 67 (75%) had OSAS. Second eye involvement was found in 10 (13.7%) of 73 patients at 3 years: 8 (15.4%) of 52 patients with OSAS at 3 years and 2 (9.5%) of 21 patients without OSAS at 3 years; P = .04. In multivariate analysis, nonadherence to ventilation treatment with continuous positive airway pressure in patients with severe OSAS increased the risk of second eye involvement (hazard ratio, 5.54; 95% CI, 1.13-27.11; P = .04).Conclusions And RelevanceThese results suggest that OSAS is common in patients with NAION and that polysomnography should be considered in these patients. These findings also suggest that patients with severe OSAS who are nonadherent to ventilation treatment with continuous positive airway pressure have an increased risk of second eye involvement.

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