High Incidence of Sleep Apnea in Patients with Retinal Vein Occlusions

Purpose: To determine the prevalence of obstructive sleep apnea (OSA) using polysomnography (PSG) in previously undiagnosed OSA patients in our prospective cohort with newly diagnosed retinal vein occlusion (RVO) and compare the incidence of OSA identified in our previously diagnosed retrospective control group of RVO subjects by past medical history (PMH). Methods: This single-center retrospective and prospective cohort study included 321 patients with branch (BRVO), hemi-central (HCRVO), or central retinal vein occlusion (CRVO) at Retina Center of New Jersey between January 2016 and October 2025. A retrospective cohort of 272 patients was compared with a prospective cohort of 49 newly diagnosed RVO patients who underwent home or laboratory-based PSG testing. Demographics, BMI, and systemic comorbidities were recorded. Standardized OSA screening questionnaires were excluded to include all patients regardless of subjective screening assessments. Primary outcomes were PSG-confirmed OSA prevalence and comparison with PMH-based OSA prevalence. Results: Among 272 retrospective RVO patients, 14 (5.15%) reported a prior diagnosis of OSA. In the prospective cohort, 4 of 49 patients (8.16%) reported severe OSA. Excluding these patients, PSG identified undiagnosed OSA in 38 of 45 patients (84.44%). PSG identified OSA in 42 of 49 patients (85.71%), including moderate-to-severe OSA in 27 patients (55.10%). Patients undergoing PSG were significantly more likely to be diagnosed with OSA than by PMH alone (85.71% vs 8.16%; risk ratio 16.65, P<0.001). Conclusions: Patients with newly diagnosed RVO demonstrate a high prevalence of previously undiagnosed OSA, suggesting RVO may serve as an important clinical indicator warranting routine PSG evaluation.