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Researchers find association between statin use, glaucoma incidence
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Short-term statin use was found to be associated with a reduced incidence of glaucoma, but no association was found with IOP, according to a study in Investigative Ophthalmology & Visual Science.
McCann and colleagues analyzed seven cohort studies, three case-control studies and one cross-sectional study involving a total of 583,615 participants. Studies were chosen because they specifically evaluated the association between statin use and the incidence or progression of glaucoma and the effect on IOP, according to the researchers.
Using odds ratios (ORs) or hazard ratios (HRs) and 95% confidence intervals (CIs), pooled ORs showed a statistically significant association between statins used up to 2 years and a reduced incidence of glaucoma. Pooled ORs of longer-term statin use did not show this.
McCann and colleagues said any evidence for the protective effect of statins against the progression of glaucoma was inconsistent, although a definition of progression was not standardized among the studies. No significant difference in IOP was associated with statin use.
“The observational design of the studies in the meta-analysis limits the ability to make inferences about whether or not exposure to statins causes reduced incidence of glaucoma,” the researchers concluded.
They suggested a prospective interventional randomized controlled study with short- and long-term follow-up to provide further insight. – by Nancy Hemphill, ELS, FAAO
Disclosures: The authors report no relevant financial disclosures.
Perspective
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Carl H. Jacobsen, OD, FAAO
By lowering cholesterol, statins help prevent cardiovascular disease in those with high cholesterol and reduce the risk of death and other poor outcomes without evidence of harm. Other consequences are independent of their effect on cholesterol; statins improve vascular function, stabilize atherosclerotic plaques, reduce inflammation, decrease platelet aggregation and possibly protect retinal ganglion cells from glaucoma-related damage. Might there be a role for statins in the pathogenesis or treatment of glaucoma?
McCann and colleagues, in their ambitious review and meta-analysis, set out to address this question. Unfortunately, only observational and case-controlled studies were available. No randomized controlled trials have been performed. Confounding factors such as use of oral beta-blockers and non-statin cholesterol-lowering drugs exist. Even so, their finding that short-term statin use is associated with a lower glaucoma incidence is welcome. Interestingly, this result appears to be pressure independent, as they found statins did not lower IOP.
Hopefully a randomized controlled study will better address possible connections between statins and glaucoma. Until that time, rest assured that your patient’s glaucoma status is likely not worse due to statin use. In fact, current evidence suggests a possible glaucoma-positive effect through use of this drug.
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