International ophthalmology · 2026
Prevalence of floppy eyelid syndrome and keratoconus in Egyptian patients with obstructive sleep apnea.
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Ahmed Islam S H, Ramadan Amir, Khamis Khalfan M, Bahgat Ahmed Yassin, Said Amr
Аннотация
PURPOSE: To describe prevalence of floppy eyelid syndrome (FES) and keratoconus (KC) in a cohort of Egyptian patients with obstructive sleep apnea (OSA).
METHODS: Six hundred patients with confirmed OSA were evaluated by 2 ophthalmologists for BCVA, slit-lamp examination, the presence of FES using vertical pull test on the upper eyelids and anterior eyelid distraction tests. All the patients underwent bilateral corneal imaging by the Scansys TA517 3D anterior segment analyzer tomography. Tomographic scans were analyzed using the manufacturer integrated KC grading software for both the front and the back corneal surface.
RESULTS: The study included 1200 eyes of OSA 600 patients with the mean age 55.02 ± 7.11 years. Two hundred sixteen patients (36%) were female. Thirty patients (5%) had a positive family history of KC. FES was identified in 96 eyes (8%) and KC in 24 eyes (2%). While univariate analysis showed a significantly higher prevalence and odds ratio for both conditions in patients with severe OSA, these associations did not remain significant in the multivariate regression model after adjusting for age, gender, and body mass index (BMI).
CONCLUSIONS: FES and KC were present in Egyptian patients with OSA. Particularly in those with higher disease severity. However, the lack of independent association in multivariate analysis suggests that systemic factors, such as BMI, may play a mediating role. Routine ophthalmological screening may be beneficial in OSA patients' multidisciplinary care.
METHODS: Six hundred patients with confirmed OSA were evaluated by 2 ophthalmologists for BCVA, slit-lamp examination, the presence of FES using vertical pull test on the upper eyelids and anterior eyelid distraction tests. All the patients underwent bilateral corneal imaging by the Scansys TA517 3D anterior segment analyzer tomography. Tomographic scans were analyzed using the manufacturer integrated KC grading software for both the front and the back corneal surface.
RESULTS: The study included 1200 eyes of OSA 600 patients with the mean age 55.02 ± 7.11 years. Two hundred sixteen patients (36%) were female. Thirty patients (5%) had a positive family history of KC. FES was identified in 96 eyes (8%) and KC in 24 eyes (2%). While univariate analysis showed a significantly higher prevalence and odds ratio for both conditions in patients with severe OSA, these associations did not remain significant in the multivariate regression model after adjusting for age, gender, and body mass index (BMI).
CONCLUSIONS: FES and KC were present in Egyptian patients with OSA. Particularly in those with higher disease severity. However, the lack of independent association in multivariate analysis suggests that systemic factors, such as BMI, may play a mediating role. Routine ophthalmological screening may be beneficial in OSA patients' multidisciplinary care.