Association of obstructive sleep apnea with central serous chorioretinopathy and choroidal thickness

Purpose: Obstructive sleep apnea (OSA) has been associated with an array of ocular disorders. This systematic review aims to investigate the association of OSA with central serous chorioretinopathy (CSCR) and subfoveal choroidal thickness changes on enhanced depth imaging optical coherence tomography. Methods: Systematic review and meta-analysis of all articles published up to November 2017 examining rate of OSA in patients with CSCR versus controls or examining subfoveal choroidal thickness measurements on enhanced depth imaging optical coherence tomography in patients with OSA versus controls. Pooled odds ratios and weighted mean difference with 95% confidence intervals (CIs) were calculated. Results: For the CSCR/OSA analysis, 7,238 patients (1,479 with CSCR and 5,759 controls) from 6 studies were eligible. For the choroidal thickness/OSA analysis, 778 eyes of 778 patients (514 with OSA and 264 controls) from 9 studies were eligible. Patients with CSCR had a 1.56 increased odds of having OSA than controls (odds ratio, 1.56; 95% CI, 1.16–2.10). There was no statistically significant difference in choroidal thickness between mild OSA subjects and controls (weighted mean difference = 23.17; 95% CI, 219.10 to 12.76). Patients with moderate OSA (weighted mean difference = 224.14; 95% CI, 242.16 to 26.12) and severe OSA (weighted mean difference = 251.19; 95% CI, 299.30 to 23.08) had thinner choroidal thickness measurements than controls. Conclusion: In summary, our results suggest that patients with CSCR are more likely to have OSA, and that moderate/severe OSA is associated with smaller subfoveal choroidal measurements on enhanced depth imaging optical coherence tomography.