Study investigates association of drugs with acute angle-closure glaucoma
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A case-crossover study conducted on a large health care database in South Korea shed light on the association between acute angle-closure glaucoma and a number of prescription and nonprescription medications.
“Understanding the association of drugs with AAC, a disease that can lead to sudden vision loss, is important in preventing the condition,” the authors wrote.
The data source was the Health Insurance Review and Assessment Service database, which contains information on the entire Korean population. A total of 13,531 patients treated for acute angle-closure (AAC) glaucoma between 2013 and 2019 were identified, and all medications used 1 to 180 days before the onset of AAC were extracted. The 30 days before onset were considered as the hazard period.
Sixty-one drugs were found to be significantly associated with AAC. Among them, sumatriptan had the highest odds of AAC development (OR = 12.60; 95% CI, 4.13-38.44) and the shortest onset time (mean 6 days), followed by topiramate (OR = 5.10; 95% CI, 2.22-11.70) and duloxetine (OR = 4.04; 95% CI, 2.95-5.54). Other antidepressants, including amitriptyline, escitalopram and nortriptyline, and anxiolytics, including alprazolam, buspirone and diazepam, showed associations with AAC.
Various medications classified in the respiratory system group, such as aminophylline, mequitazine and piprinhydrinate, showed associations with AAC, and so did drugs for the alimentary tract and metabolism, such as lactulose, metoclopramide and dimenhydrinate. Among NSAIDs, naproxen had the highest association, followed ibuprofen. Antibiotics such as levofloxacin, ofloxacin and clarithromycin and corticosteroids such as prednisolone and methylprednisolone were also associated.
Overall, 36.6% of the AAC cases in the study were likely to be induced by individual or multiple medications taken simultaneously.
“The results of this study suggest that patients who are prescribed these drugs may be at risk of developing AAC. Clinicians should be aware of the increased risk, provide appropriate explanations to the patient, conduct an ophthalmic examination and take precautionary measures when other risk factors for AAC are present,” the authors wrote.
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