Beta-blocker use associated with higher incidence of cataract and surgery

Br J Ophthalmol. 2009;doi:10.1136/bjo.2008.153379.

Use of oral or topical beta-blockers was correlated with an elevated incidence of nuclear cataract and subsequent cataract surgery, a large study showed.

"Given the limitations and the possibility of various biases in our study, these findings should be interpreted with caution," the study authors said. "Nevertheless, the biological plausibility for an association between beta-blocker use and cataract, and the internal consistency of this finding for use of both oral and topical beta-blockers, warrants further study."

The study included subjects participating in the Blue Mountains Eye Study, a population-based cohort survey. Subjects were age 49 years or older. Baseline examinations included 3,654 subjects; 2,335 subjects were examined at 5 years, and 1,952 subjects were examined at 10 years.

Study participants answered interviewer-administered questionnaires on medication use and underwent comprehensive eye examinations, including slit lamp and retroillumination photography. The Wisconsin Cataract Grading System was used to gauge nuclear cataract type and severity. Results were adjusted for age, gender, blood pressure, smoking status, diabetes, myopia, socioeconomic status and steroid use.

Study data showed a borderline association between use of oral or topical beta-blockers and nuclear cataract. Beta-blocker use also predicted incident cataract surgery. Use of ACE inhibitors was not associated with the incidence of any cataract type. However, ACE inhibitors were associated with the incidence of cataract surgery.

Loop diuretics and potassium sparing diuretics showed no significant association with cataract subtype or incidence of cataract surgery, the authors said.