{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T19:54:34Z","timestamp":1789588474810,"version":"build-2803163510"},"reference-count":22,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vision"],"abstract":"<jats:p>Obstructive sleep apnea (OSA) is a common condition associated with intermittent hypoxia, systemic inflammation, and vascular dysfunction; mechanisms implicated in retinal disease pathogenesis. This real-world retrospective cohort study used data from the TriNetX Research Network to assess whether continuous positive airway pressure (CPAP) therapy reduces retinal disease incidence among adults with OSA and BMI between 25.0 and 30.0 kg\/m2. After 1:1 propensity score matching, 101,754 patients were included in the analysis. Retinal outcomes included diabetic retinopathy (DR), age-related macular degeneration (AMD), retinal vein occlusion (RVO), and central serous chorioretinopathy (CSC). CPAP use was associated with a modest but statistically significant reduction in DR (3.2% vs. 3.4%, RR: 0.922, p = 0.016) and AMD (2.1% vs. 2.3%, RR: 0.906, p = 0.018), while no significant differences were found for RVO or CSC. These findings support prior evidence linking CPAP to improved retinal microvascular health and suggest a protective effect against specific retinal complications. Limitations include a lack of data on CPAP adherence, OSA severity, and imaging confirmation. Still, this study highlights the importance of interdisciplinary care between sleep and eye health, and the need for further prospective studies to validate CPAP\u2019s role in preventing retinal disease progression in OSA patients.<\/jats:p>","DOI":"10.3390\/vision9030065","type":"journal-article","created":{"date-parts":[[2025,8,5]],"date-time":"2025-08-05T08:46:55Z","timestamp":1754383615000},"page":"65","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["CPAP Use and Retinal Disease Risk in Obstructive Apnea: A Cohort Study"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-7948-154X","authenticated-orcid":false,"given":"Dillan Cunha","family":"Amaral","sequence":"first","affiliation":[{"name":"Department of Ophthalmology and Otorhinolaryngology, Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro 21941-853, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1840-2953","authenticated-orcid":false,"given":"Pedro Lucas Machado","family":"Magalh\u00e3es","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Institute of Medical Education, Angra dos Reis 23914-360, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7899-5443","authenticated-orcid":false,"given":"Muhammad","family":"Alfatih","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universitas Indonesia, Jakarta 16424, Indonesia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruna Gabriel","family":"Miranda","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Federal University of Catal\u00e3o, Catal\u00e3o 75705-220, GO, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2953-2188","authenticated-orcid":false,"given":"Hashem","family":"Abu Serhan","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Hamad Medical Corporation, Doha P.O. Box 3050, Qatar"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4524-8661","authenticated-orcid":false,"given":"Ra\u00edza","family":"Jacometti","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Otorhinolaryngology, Faculty of Medicine, University of S\u00e3o Paulo, S\u00e3o Paulo 05508-220, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3555-9122","authenticated-orcid":false,"given":"Bruno Fortaleza de Aquino","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Otorhinolaryngology, Faculty of Medicine, University of S\u00e3o Paulo, S\u00e3o Paulo 05508-220, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Let\u00edcia","family":"Sant\u2019Ana","sequence":"additional","affiliation":[{"name":"Hospital Alem\u00e3o Oswaldo Cruz, S\u00e3o Paulo 01323-020, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1474-1849","authenticated-orcid":false,"given":"Diogo Haddad","family":"Santos","sequence":"additional","affiliation":[{"name":"Hospital Alem\u00e3o Oswaldo Cruz, S\u00e3o Paulo 01323-020, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M\u00e1rio Luiz Ribeiro","family":"Monteiro","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Otorhinolaryngology, Faculty of Medicine, University of S\u00e3o Paulo, S\u00e3o Paulo 05508-220, SP, Brazil"},{"name":"Laboratory for Investigation in Ophthalmology (LIM-33), Division of Ophthalmology, Faculty of Medicine, University of S\u00e3o Paulo, S\u00e3o Paulo 01246-903, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9610-5768","authenticated-orcid":false,"given":"Ricardo Noguera","family":"Louzada","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Otorhinolaryngology, Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro 21941-853, RJ, Brazil"},{"name":"Department of Ophthalmology and Otorhinolaryngology, Faculty of Medicine, University of S\u00e3o Paulo, S\u00e3o Paulo 05508-220, SP, Brazil"},{"name":"Laboratory for Investigation in Ophthalmology (LIM-33), Division of Ophthalmology, Faculty of Medicine, University of S\u00e3o Paulo, S\u00e3o Paulo 01246-903, SP, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1080\/02713683.2016.1238942","article-title":"Changes of Retinal Nerve Fiber Layer Thickness in Obstructive Sleep Apnea Syndrome: A Systematic Review and Meta-analysis","volume":"42","author":"Wang","year":"2017","journal-title":"Curr. 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