Kongchan P.Banhiran W.Chirapapaisan N.Kasemsuk N.Mahidol University2025-05-152025-05-152025-05-01Journal of Clinical Sleep Medicine Vol.21 No.5 (2025) , 907-91515509389https://repository.li.mahidol.ac.th/handle/123456789/110138Study Objectives: To assess the effect of continuous positive airway pressure (CPAP) therapy on intraocular pressure in patients with obstructive sleep apnea. Methods: The search was performed in Ovid Medline and Embase database, then followed by a manual bibliography search. Abstract search and screening were independently performed followed by eligible full-text versions reviewed. Then disagreements were discussed in a group. Results: This systematic review and meta-analysis considered 15 studies with 495 participants. The pooled mean intraocular pressure after CPAP therapy shows no significant difference compared to the baseline (mean difference, 0.58 mmHg; 95% confidence interval, 20.33 to 1.19). Subgroup analysis shows significantly higher intraocular pressure after in-laboratory positive airway pressure titration and after long-term CPAP use (mean difference, 4.28 mmHg; 95% confidence interval, 0.91–7.66; mean difference, 0.45 mmHg; 95% confidence interval, 0.07–0.83; respectively). Ocular perfusion pressure was also significantly decreased after CPAP therapy (mean difference, 22.15 mmHg; 95% confidence interval, 23.50 to 20.80). The pooled data showed no significant difference in retinal nerve fiber layer thickness and macular layer thickness. Conclusions: After long-term treatment CPAP therapy, there is a significant increase in intraocular pressure in patients with obstructive sleep apnea and a decrease in ocular perfusion pressure, but no significant difference in other ophthalmologic parameters is shown. For this reason, CPAP usage in patients with glaucoma necessitates to be done cautiously.NeuroscienceMedicineReviewSCOPUS10.5664/jcsm.115522-s2.0-1050044419701550939739815722