This article is more than 5 years old. Information may no longer be current.
High cholesterol levels increase risk of primary open-angle glaucoma
Click Here to Manage Email Alerts
High serum cholesterol levels are associated with increased risk for primary open-angle glaucoma, while 5 or more years of statin use decrease the risk, a recent study suggests.
“We observed a trend of higher risk of primary open angle glaucoma with higher serum cholesterol levels,” the authors wrote. “As in other studies, a history of statin use was modestly inversely associated with primary open angle glaucoma in our study.”
Researchers studied self-reported information from 136,782 glaucoma-free adults at least 40 years old who had eye examinations. Participants were stratified into three population-based cohorts, including the Nurses’ Health Study (N = 50,710, followed up from 2000 to 2014), the Nurses’ Health Study 2 (N = 62,992, followed up from 1999 to 2015) and the Health Professionals Follow-up Study (N = 23,080, followed up from 2000 to 2014). The analysis was performed in in January 2019, using data from 1999 to 2000 as a baseline.
Within the 886 cases of primary open-angle glaucoma (POAG) identified, each 20 mg/dL increase in total serum cholesterol was associated with a 7% increase in risk for POAG (95% CI, 1.02–1.11), with self-reported history of elevated cholesterol also correlating with higher risk for POAG (RR=1.17; 95% CI, 1-1.37). Conversely, statin use for 5 or more years vs. no use of statins was associated with a 21% lower risk of POAG (RR=0.79; 95% CI, 0.65–0.97), with a more inverse correlation in participants at least 65 years old (RR=0.70; 95% CI, 0.56–0.87) vs. adults younger than 65 (RR=1.05; 95% CI, 0.68–1.63).
“Our study was observational, but a definitive means of assessing the association between statin use and POAG would be to conduct a randomized clinical trial,” the researchers wrote. “Further studies are warranted to confirm these results, especially given the widespread use of statins in older persons at particular risk for POAG.” – by Eamon Dreisbach
Disclosures: Kang reported no relevant financial disclosures. Please see the full study for a list of all other authors’ disclosures.
Perspective
Back to Top
Mark Eltis, OD, FAAO
Several studies have identified a potential link between high cholesterol and increased glaucoma risk. There has also been mounting evidence to suggest that statin use is protective against POAG progression. Statins have been associated with a reduction in IOP and may also shield ganglion cells from the harmful effects of the disease. However, there is no consensus on this issue, as some dissenting research has claimed that statins increase glaucoma risk. The jury is still out.
When anxious glaucoma patients ask me what they should do (other than the prescribed treatment) to avoid progression, I always advocate a healthy lifestyle, which includes eating right, stress reduction and exercising. Up until recently there was very little scientific evidence to support this.
The finding that statins could offer a form of IOP control and potential neuroprotection is a great cause for hope. This would not only highlight the intersection of healthy living and glaucoma prevention but might also open a new pharmacological front in the fight against POAG. While this particular study was limited by likely self-reporting errors and homogenous subjects, it offers a potential pathway to progress in glaucoma care.
Click Here to Manage Email Alerts