{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T16:05:36Z","timestamp":1790697936515,"version":"4.1.0"},"reference-count":34,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2021,3,1]],"date-time":"2021-03-01T00:00:00Z","timestamp":1614556800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of VitreoRetinal Diseases"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>This work reports the association of obstructive sleep apnea (OSA) and cotton-wool spots (CWS) seen in patients with nonproliferative diabetic retinopathy (DR).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A random sample of patients diagnosed with DR between January 1, 2015 and December 31, 2018, were selected from medical-billing codes. Dilated funduscopic examination findings and medical history were analyzed by reviewing medical records.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      CWS were present in 12 of 118 patients without OSA, compared with 11 of 32 patients with OSA (10.2% vs 34.4%, respectively; P = .002). OSA was more common in men (68.8%, P = .03) and associated with a higher body mass index (30.0 \u00b1 5.0 without OSA vs 33.6 \u00b1 5.5 with OSA, P &lt; .001). When comparing those with and without OSA, there was no association with age; glycated hemoglobin A\n                      <jats:sub>1c<\/jats:sub>\n                      ; stage of DR; insulin dependence; presence of diabetic macular edema; smoking status; or a history of hypertension, hyperlipidemia, cardiovascular disease, or other breathing disorder.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>The presence of OSA is associated with CWS in patients with DR, as well as male sex and a higher body mass index. Further research is needed to determine the ophthalmologist\u2019s role in the timely referral of patients with CWS for OSA evaluation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/2474126421989576","type":"journal-article","created":{"date-parts":[[2021,3,1]],"date-time":"2021-03-01T04:33:43Z","timestamp":1614573223000},"page":"495-500","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["The Association Between Obstructive Sleep Apnea and Cotton-Wool Spots in Nonproliferative Diabetic Retinopathy"],"prefix":"10.1177","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7480-0076","authenticated-orcid":false,"given":"Halward M.J.","family":"Blegen","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Wilford Hall Ambulatory Surgical Center, San Antonio, TX, USA"},{"name":"Department of Ophthalmology, Brooke Army Medical Center, San Antonio, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6084-6399","authenticated-orcid":false,"given":"Grant A.","family":"Justin","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Wilford Hall Ambulatory Surgical Center, San Antonio, TX, USA"},{"name":"Department of Ophthalmology, Brooke Army Medical Center, San Antonio, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley A.","family":"Bishop","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Brooke Army Medical Center, San Antonio, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4966-6228","authenticated-orcid":false,"given":"Anthony R.","family":"Cox","sequence":"additional","affiliation":[{"name":"Uniformed Services University of the Health Sciences, Bethesda, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,3,1]]},"reference":[{"key":"bibr1-2474126421989576","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000132"},{"key":"bibr2-2474126421989576","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph16173101"},{"issue":"2","key":"bibr3-2474126421989576","first-page":"97","volume":"64","author":"Maspero C","year":"2015","journal-title":"Minerva 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