Observational studyAmerican journal of ophthalmology2025
Impact of Obstructive Sleep Apnea on Diabetic Retinopathy Progression and Systemic Complications.
Observational study in American journal of ophthalmology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Association between obstructive sleep apnea syndrome and the risk of diabetic retinopathy: a meta-analysis of cohort studies.Frontiers in endocrinology · 2026Pooled it
- Role of systemic hypoxia in the progression of diabetic retinopathy: a propensity-matched retrospective cohort study.BMJ open ophthalmology · 2026Article
- Association of High-Risk Obstructive Sleep Apnea with Microvascular Complications in Adults with Type 1 Diabetes Mellitus: A Case-Control Study.Journal of clinical medicine · 2026Article
- An evening chronotype is associated with the incidence and progression of diabetic retinopathy in people with type 2 diabetes mellitus: a cohort study.Diabetologia · 2026Observational
- Article
- Hormonal metabolic burden in diabetic retinopathy: the diabetic retina as an endocrine-responsive target organ.Frontiers in endocrinology · 2026Review
- CPAP Use and Retinal Disease Risk in Obstructive Apnea: A Cohort Study.Vision (Basel, Switzerland) · 2025Article
- A Structured Narrative Review of the OSA-T2DM Axis.Journal of clinical medicine · 2025Review
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
purposeTo evaluate the risk of diabetic retinopathy progression and systemic vascular events, including death, in patients with nonproliferative diabetic retinopathy (NPDR) with obstructive sleep apnea (OSA).
designRetrospective cohort study.
methodsElectronic chart query using TriNetX, an electronic health records network comprising data from over 124 million patients. Patients with NPDR with and without OSA were identified. Patients were excluded if they had a history of proliferative disease (proliferative diabetic retinopathy), diabetic macular edema, or prior ocular intervention (intravitreal injection, laser, or pars plana vitrectomy). Propensity score matching was performed to control for baseline demographics and comorbidities. The rate of progression to vision-threatening complications, need for ocular intervention, and systemic events was measured at 1, 3, and 5 years.
resultsA total of 11 931 patients in each group were analyzed after propensity score matching. There was an elevated risk of proliferative diabetic retinopathy in the OSA cohort at 1 (risk ratio [RR]: 1.34, P < .001), 3 (RR: 1.31, P < .001), and 5 years (RR: 1.28, P < .001). There was an elevated risk of diabetic macular edema in the OSA group at all time points: 1 (RR: 1.31, P < .001), 3 (RR: 1.19, P<.001), and 5 years (RR: 1.18, P < .001). With respect to ocular interventions, there was an increased risk of intravitreal injection in patients with OSA at 1 (RR: 1.59, P < .001), 3 (RR: 1.58, P < .001), and 5 years (RR: 1.54, P < .001), and similar trends were noted with laser photocoagulation, but not vitrectomy. Regarding systemic events, patients with NPDR with OSA had a greater risk of stroke (1 year RR: 1.80, P < .001; 3 years RR: 1.56, P < .001; and 5 years RR: 1.49, P < .001), myocardial infarction (1 year RR: 1.51, P < .001; 3 years RR: 1.46, P < .001; and 5 years RR: 1.43, P < .001), and death (1 year RR: 1.31, P < .001; 3 years RR: 1.19, P < .001; and 5 years RR: 1.15, P < .001).
conclusionsThere is an increased rate of diabetic retinopathy progression to vision-threatening complications, need for ocular intervention, and systemic complications, including death, for patients with OSA. We emphasize the need for improved screening measures of patients with NPDR and potential OSA.
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