Relationship between diabetic retinopathy and sleep-disordered breathing

Purpose: To clarify the relationships of sleep-disordered breathing (SDB) to nonproliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR).

Design: Cross sectional case-control study.

Methods: Forty-eight consecutive NPDR and 118 PDR cases that had undergone surgery in our hospital were included in this study. Pulse oximetry was conducted during the night and the sleeping 4% oxygen desaturation index (ODI) (number of oxygen desaturation events/hour exceeding 4%) and mean SpO(2)% were calculated. If 4% ODI > 5 times/hour, SDB was diagnosed. The results were evaluated and compared between the 2 groups. In addition, these results and preoperative patient background factors were analyzed using multiple regression analysis to identify correlations with the diagnosis of PDR.

Results: Twenty-nine percent of the NPDR and 48% of the PDR patients were diagnosed as having SDB. The incidence of SDB and the 4% ODI/hour value were significantly higher in the PDR than in the NPDR group (P = .003 and .03, respectively). Multiple regression analysis showed younger age and a higher 4% ODI value to be factors independently contributing to a diagnosis of PDR (age, standard regression coefficient = -0.34; t value = -4.44; P < .0001; 4% ODI, standard regression coefficient = 0.20; t value = 2.15; P = .03, correlation coefficient (R) = 0.43).

Conclusion: Our results suggest that, in diabetic retinopathy patients with nocturnal desaturation, reoxygenation caused by SDB may relate to the development of PDR.

Shiba T., Sato Y., Takahashi M. Relationship between diabetic retinopathy and sleep-disordered breathing. Am J Ophthalmol. 2009;147(6):1017-21.
doi: 10.1016/j.ajo.2008.12.027.