Work

Eyelid ptosis and dermatochalasis in obese patients with obstructive sleep apnoea: A large-scale propensity score-matched analysis

Year: 2025

Type: article

Abstract: BACKGROUND/OBJECTIVES: While obstructive sleep apnoea (OSA) has been associated with various ocular manifestations, the relationship between OSA and eyelid disorders beyond floppy eyelid syndrome remains poorly characterised. This study investigated the association between OSA and eyelid ptosis and dermatochalasis in obese patients. SUBJECTS/METHODS: A retrospective propensity score-matched cohort study was conducted using the TriNetX Research Network database (2015-2024). Obese patients with OSA confirmed by CPAP initiation (n = 315,223) were matched 1:1 with obese controls without OSA (n = 315,223) based on demographics and comorbidities. Primary outcomes included eyelid ptosis and dermatochalasis occurring after OSA diagnosis, analysed both as a composite outcome and as separate individual outcomes. Statistical analysis included risk ratios, odds ratios, number needed to harm (NNH), and time-to-event analysis with 95% confidence intervals. RESULTS: Eyelid complications occurred in 7600 OSA patients (2.41%) versus 3890 controls (1.23%). OSA patients demonstrated significantly increased risk (risk ratio 1.95, 95% CI 1.88-2.03; odds ratio 1.98, 95% CI 1.90-2.06; NNH 119 patients, 95% CI 110-130; p < 0.0001). When analysed separately, ptosis occurred in 4760 OSA patients (1.51%) versus 2,112 controls (0.67%) with risk ratio 2.25 (95% CI 2.14-2.37, p < 0.0001). Dermatochalasis occurred in 4192 OSA patients (1.33%) versus 2207 controls (0.70%) with risk ratio 1.90 (95% CI 1.81-2.01, p < 0.0001). CONCLUSION: OSA is independently associated with a nearly two-fold increased risk of eyelid ptosis and dermatochalasis in obese patients, beyond the known association with floppy eyelid syndrome. These findings support enhanced ophthalmologic surveillance in OSA patients and highlight the importance of recognising ocular manifestations in sleep disorder populations.

Source: Eye

DOI: 10.1038/s41433-025-04164-8

Authors: Aaron T. Zhao, Catherine Z. Shen, William R. Katowitz

Institutions: University of Pennsylvania, Children's Hospital of Philadelphia

Language: English

Topic: Obstructive Sleep Apnea Research

Subfield: Physiology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,590