IMPACT OF SLEEP APNEA ON RETINAL VEIN OCCLUSION IN INDIVIDUALS 55 AND YOUNGER: A Retrospective Cohort Study.

PURPOSE: Sleep apnea (SA) is a systemic vascular risk factor, but its association with retinal vein occlusion (RVO) in younger adults is unclear. This study evaluated the relationship between SA and RVO, including central RVO and branch RVO, in individuals ≤55 years.

METHODS

A retrospective cohort study was conducted using the TriNetX US Collaborative Network (August 2005-2025). Patients ≤55 years with SA (N = 2,087,539) were propensity score-matched 1:1 with controls (N = 2,087,539) by age, sex, race, body mass index, and comorbidities. Outcomes included incident RVO, central RVO, and branch RVO. Risk ratios, hazard ratios, and Kaplan-Meier cumulative incidence analysis with log-rank tests were performed.

RESULTS

Among 2,087,539 patients per group, 547 SA patients (0.026%) and 475 controls (0.023%) developed RVO (risk ratio = 1.152, 95% confidence interval: 1.018-1.302; P = 0.024; hazard ratio = 1.219, 95% confidence interval: 1.078-1.378; χ 2 = 9.958; P = 0.002). Branch RVO occurred in 305 SA patients (0.015%) versus 237 controls (0.011%) (risk ratio = 1.287, 95% confidence interval: 1.086-1.525; P = 0.003; hazard ratio = 1.367, 95% confidence interval: 1.153-1.619; χ 2 = 13.109; P < 0.001).

CONCLUSION

Sleep apnea was associated with increased risk of RVO in younger adults, primarily driven by branch RVO. These findings highlight the need for early recognition and management of SA to mitigate retinal vascular complications.