Luke Yaldo, MA, of the University of Miami Miller School of Medicine, spoke with Ophthalmology 360 at the 2026 ASCRS Annual Meeting about the link between obstructive sleep apnea (OSA) and age-related macular degeneration (AMD) and how modifying patients’ risk of OSA may help their vision long-term.
Luke Yaldo, MA:
Hi, my name is Luke Yaldo, MA. I’m a medical student at the University of Miami Miller School of Medicine, and I had the pleasure of presenting my paper on the relationship between sleep apnea (OSA) and age-related macular degeneration (AMD) here at ASCRS 2026. It was a systematic review and meta-analysis that was done with my mentors at the Bascom Palmer Eye Institute.
The reason we did this study, the questions that we wanted to answer was, does OSA, which is a condition that is characterized by vascular dysregulation, oxidative damage, put patients at a higher risk of developing AMD? Because AMD, we do know that choroidal ischemia, vascular dysregulation, these biological overlaps do exist. The data between OSA and AMD has been a little bit sparse. We wanted to further uncover that mystery. We did a systematic review, which included 8 studies and a meta-analysis, which involved over 3.5 million patients, so it was a very big data set, especially for this field and this topic.
What we uncovered in our analysis was that patients who had OSA had a 1.44 odds ratio of developing AMD and a 1.66 hazard ratio. What does that mean? Patients with OSA had a 44% higher chance of having AMD and a 66% higher chance of developing AMD, a hazard of developing AMD within the study period, which did range because a lot of studies were included in it. Now, I think it’s important to mention that this is very observational data, so correlation doesn’t imply causation. It doesn’t tell us that OSA is causing AMD, but it does set a really strong foundational reason as to why we should now be studying it a lot more deeper and a lot more further.
I think the reason why it’s very exciting is that OSA is not genetics, it’s not age, it’s modifiable. There’s CPAP machines, there’s mandibular devices, there’s even surgical treatments for OSA. If we can uncover the fact that OSA might be a strong factor for developing AMD and it’s a modifiable risk factor, that would be a huge addition to a very limited toolkit, a very limited arsenal that we have at the prevention of AMD.
I think as far as where we are now, the take-home for clinical practice and for eye care professionals is not that we necessarily need to start questioning everybody with AMD about whether they have sleep apnea, but I think some general questions in our histories that are very simple to work in. Do they have witnessed apneic episodes, daytime sleepiness, loud snoring can be good things to pick up and understand about patients. Because if we’re the ones to pick those up and get them referrals to sleep studies or specialists that can help treat that, then not only are we helping the patient’s overall health, but we could be improving a modifiable risk factor for their eye health as well.
Future research that we’re going to be doing is looking more into studies that have less heterogeneity on the definitions of OSA and of AMD and trying to get deeper to the causation and the reasons behind the link.
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