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Review
. 2025 Jul 11;26(14):6649.
doi: 10.3390/ijms26146649.

Neuro-Ophthalmological Disorders Associated with Obstructive Sleep Apnoea

Snježana Kaštelan  1 , Lea Kozina  2 , Maja Alaber  3 , Zora Tomić  4 , Marina Andrešić  5 , Ivana Bakija  6 , Diana Bućan  7 , Tomislav Matejić  8 , Domagoj Vidović  2
Affiliations
Review

Neuro-Ophthalmological Disorders Associated with Obstructive Sleep Apnoea

Snježana Kaštelan et al. Int J Mol Sci. .

Abstract

Obstructive sleep apnoea (OSA) is a prevalent condition characterised by intermittent upper airway obstruction during sleep, resulting in recurrent hypoxia and sleep fragmentation. Emerging evidence highlights the significant impact of OSA on neuro-ophthalmological health, linking it to conditions such as glaucoma, optic neuropathy, papilledema, and visual field defects. These associations emphasise the importance of understanding the mechanisms connecting OSA to neuro-ophthalmological disorders to enhance early diagnosis and management. This review explores the pathophysiological pathways, including hypoxia-induced vascular dysregulation, oxidative stress, inflammation, and intracranial pressure fluctuations, that contribute to ocular and neurological impairments in OSA patients. Advanced diagnostic tools, such as optical coherence tomography and polysomnography, offer promising avenues for detecting subclinical neuro-ophthalmological changes, enabling timely intervention. Management strategies, primarily centred on continuous positive airway pressure therapy, have shown efficacy in mitigating OSA-related neuro-ophthalmological complications. However, surgical and pharmacological interventions and lifestyle modifications remain vital components of a multidisciplinary approach to care. Despite advancements, significant research gaps persist, particularly in understanding the long-term impact of OSA treatment on neuro-ophthalmological outcomes and identifying specific biomarkers for early detection. Future research should prioritise longitudinal studies, interdisciplinary collaborations, and personalised medicine approaches to address these challenges. Recognising and treating neuro-ophthalmological disorders in OSA patients is imperative for improving quality of life and preventing irreversible visual and neurological damage.

Keywords: glaucoma; intermittent hypoxia; intracranial pressure; molecular mechanisms; neuro-ophthalmology; obstructive sleep apnoea; optic nerve; oxidative stress; retinal changes; visual function.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Summary of the ocular and systemic effects of CPAP therapy.
Figure 2
Figure 2
Recommendations for research, diagnosis, and monitoring of neuro-ophthalmological disorders in obstructive sleep apnoea patients.
See this image and copyright information in PMC

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