{"id":333,"date":"2015-01-23T13:05:11","date_gmt":"2015-01-23T15:05:11","guid":{"rendered":"http:\/\/www.planetaw.com.br\/temp\/sbg\/?p=333"},"modified":"2019-06-24T13:15:02","modified_gmt":"2019-06-24T16:15:02","slug":"apneia-do-sono-e-aumento-do-risco-para-glaucoma","status":"publish","type":"post","link":"https:\/\/www.sbglaucoma.org.br\/medico\/apneia-do-sono-e-aumento-do-risco-para-glaucoma\/","title":{"rendered":"APN\u00c9IA DO SONO E AUMENTO DO RISCO PARA GLAUCOMA"},"content":{"rendered":"
\n
\"\"Editor Associado e Comentarios por Luciana Alencar sobre<\/strong>:
\nRef.: Obstructive sleep apnea and increased risk of glaucoma: a population-based matched-cohort study<\/strong>.
\nLin CC, Hu CC, Ho JD, Chiu HW, Lin HC.
\nOphthalmology. 2013 Aug;120(8):1559-64<\/strong>
\n<\/span><\/div>\n<\/div>\n

Muitos fatores de risco j\u00e1 foram estudados e mostraram associa\u00e7\u00e3o com o desenvolvimento do glaucoma. Apesar de a press\u00e3o intraocular ser um fator determinante, o limiar individual para desencadear as altera\u00e7\u00f5es glaucomatosas \u00e9 muito vari\u00e1vel.<\/span> Nos \u00faltimos anos diversos estudos avaliaram se h\u00e1 uma associa\u00e7\u00e3o entre a s\u00edndrome da apneia obstrutiva do sono (SAOS) e o glaucoma. A apneia do sono caracteriza-se por epis\u00f3dios repetidos de fechamento parcial ou total das vias a\u00e9reas superiores durante o sono. Sua preval\u00eancia era estimada em n\u00e3o mais que 10%; no entanto, estudos nos \u00faltimos anos sugerem que esta preval\u00eancia possa chegar a 30%. A hip\u00f3xia e hipercapnia resultantes da SAOS levam a estimula\u00e7\u00e3o simp\u00e1tica, arritmias, hipertens\u00e3o arterial, aterosclerose, etc., e essas altera\u00e7\u00f5es vasculares sist\u00eamicas podem ser delet\u00e9rias tamb\u00e9m ao nervo \u00f3ptico.
\nO estudo de Lin et al. utilizou o banco de dados do programa nacional de sa\u00fade de Taiwan para selecionar pacientes rec\u00e9m diagnosticados com SAOS por meio de polissonografia, e pacientes controles (de mesma faixa et\u00e1ria, mesmo n\u00edvel de urbaniza\u00e7\u00e3o, mesmo n\u00famero de consultas, e mesmo tempo de seguimento), para assim comparar a incid\u00eancia de glaucoma nos dois grupos. Os autores observaram uma incid\u00eancia de glaucoma prim\u00e1rio de \u00e2ngulo aberto nos pacientes com apneia do sono maior do que no grupo controle, sendo de 11,26 para cada 1000 indiv\u00edduos no grupo com SAOS e de 6,76 para cada 1000 indiv\u00edduos no grupo controle. O estudo mostrou que, para um per\u00edodo de 5 anos, os pacientes com SAOS apresentam uma chance 67% maior de desenvolver glaucoma do que pacientes sem SAOS.<\/span><\/p>\n

“Embora esses resultados n\u00e3o comprovem qualquer rela\u00e7\u00e3o causal, eles sugerem que existe uma associa\u00e7\u00e3o entre as duas doen\u00e7as.”<\/span>Embora esses resultados n\u00e3o comprovem qualquer rela\u00e7\u00e3o causal, eles sugerem que existe uma associa\u00e7\u00e3o entre as duas doen\u00e7as.O desenho do estudo n\u00e3o permite, entretanto, avaliar se a correla\u00e7\u00e3o \u00e9 direta ou associada a outros fatores. Como exemplo, os pacientes com apneia do sono possu\u00edam tamb\u00e9m com maior frequ\u00eancia outras doen\u00e7as cardiovasculares. Al\u00e9m disso, algumas perguntas permanecem sem resposta: o tratamento da SAOS previne ou retarda o desenvolvimento\/progressao da neuropatia optica glaucomatosa? H\u00e1 benef\u00edcio associado na redu\u00e7\u00e3o da press\u00e3o intraocular nesses casos?<\/span><\/p>\n

Veja coment\u00e1rios do International Glaucoma Review sobre este artigo:
\nhttp:\/\/www.e-igr.com\/ES\/index.php?issue=152&ComID=1260<\/a><\/p>\n

\n
\n

Resumo deste artigo<\/h3>\n
\n
\n
\n

Ophthalmology<\/em>. 2013 Aug;120(8):1559-64. doi: 10.1016\/j.ophtha.2013.01.006. Epub 2013 Apr 17.
\nObstructive sleep apnea and increased risk of glaucoma: a population-based matched-cohort study.<\/strong>
\nLin CC, Hu CC, Ho JD, Chiu HW, Lin HC..
\nAuthor information<\/strong><\/p>\n

Abstract<\/strong><\/p>\n

PURPOSE<\/strong>:
\nPrevious studies had reported an increased prevalence of glaucoma in patients with obstructive sleep apnea (OSA). However, the risk of open-angle glaucoma (OAG) among patients with OSA remains unclear. Using a nationwide, population-based dataset in Taiwan, this study aimed to examine the prevalence and risk of OAG among patients with OSA during a 5-year follow-up period after a diagnosis of OSA.<\/p>\n

DESIGN<\/strong>:
\nA retrospective, matched-cohort study.
\nPARTICIPANTS AND CONTROLS<\/strong>:
\nThis study used data sourced from the Longitudinal Health Insurance Database 2000. We included 1012 subjects with OSA in the study cohort and randomly selected 6072 subjects in the comparison group.<\/p>\n

METHODS<\/strong>:
\nEach subject in this study was individually traced for a 5-year period to identify those subjects who subsequently received a diagnosis of OAG. Cox proportional hazards regression was performed to calculate the 5-year risk of OAG between the study and comparison cohorts.<\/p>\n

MAIN OUTCOME MEASURES<\/strong>:
\nThe incidence and risk of OAG between the study and comparison groups.<\/p>\n

RESULTS<\/strong>:
\nDuring the 5-year follow-up period, the incidence rate per 1000 person-years was 11.26 (95% confidence interval [CI], 8.61-14.49) and 6.76 (95% CI, 5.80-7.83) for subjects with and without OSA, respectively. After adjusting for monthly income, geographic region, diabetes, hypertension, coronary heart disease, obesity, hyperlipidemia, renal disease, hypothyroidism, and the number of outpatient visits for ophthalmologic care during the follow-up period, stratified Cox proportional hazards regression revealed that the hazard ratio for OAG within the 5-year period for subjects with OSA was 1.67 (95% CI, 1.30-2.17; P<0.001) that of comparison subjects.<\/p>\n

CONCLUSIONS<\/strong>:
\nOur results suggest that OSA is associated with an increased risk of subsequent OAG diagnosis during a 5-year follow-up period.<\/p>\n

FINANCIAL DISCLOSURES(S)<\/strong>:
\nThe authors have no proprietary or commercial interest in any of the materials discussed in this article.<\/p>\n

Copyright \u00a9 2013 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
\nPMID: 23601803 [PubMed – indexed for MEDLINE]<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"

Editor Associado e Comentarios por Luciana Alencar sobre: Ref.: Obstructive sleep apnea and increased risk of glaucoma: a population-based matched-cohort study. Lin CC, Hu CC, Ho JD, Chiu HW, Lin HC. Ophthalmology. 2013 Aug;120(8):1559-64 Muitos fatores de risco j\u00e1 foram estudados e mostraram associa\u00e7\u00e3o com o desenvolvimento do glaucoma. Apesar de a press\u00e3o intraocular ser […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_joinchat":[],"footnotes":""},"categories":[1],"tags":[],"class_list":["post-333","post","type-post","status-publish","format-standard","hentry","category-sem-categoria"],"acf":[],"yoast_head":"\nAPN\u00c9IA DO SONO E AUMENTO DO RISCO PARA GLAUCOMA - SBG - Sociedade Brasileira de Glaucoma<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.sbglaucoma.org.br\/medico\/apneia-do-sono-e-aumento-do-risco-para-glaucoma\/\" \/>\n<meta property=\"og:locale\" content=\"pt_BR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"APN\u00c9IA DO SONO E AUMENTO DO RISCO PARA GLAUCOMA - SBG - Sociedade Brasileira de Glaucoma\" \/>\n<meta property=\"og:description\" content=\"Editor Associado e Comentarios por Luciana Alencar sobre: Ref.: Obstructive sleep apnea and increased risk of glaucoma: a population-based matched-cohort study. Lin CC, Hu CC, Ho JD, Chiu HW, Lin HC. Ophthalmology. 2013 Aug;120(8):1559-64 Muitos fatores de risco j\u00e1 foram estudados e mostraram associa\u00e7\u00e3o com o desenvolvimento do glaucoma. 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