TOPLINE

The use of cholesterol-lowering statins was associated with a 15% lower risk of developing open-angle glaucoma at 5 years and with a substantially reduced need for laser or surgery in patients who already had the condition. The associations held up, although somewhat weaker, at 10 years, and were seen with drugs such as atorvastatin and rosuvastatin.

METHODOLOGY

• Researchers conducted a retrospective cohort study of de-identified health records from the TriNetX network to compare the onset of glaucoma and the need for treatment among users vs nonusers of statins at 5 and 10 years.
• To assess the onset of glaucoma, they compared 210,701 adults aged 40 years or older who had an eye exam within a year before starting a statin with an equal number of matched adults with eye care records and no record of statin use; those with a prior diagnosis of glaucoma were excluded.
• To assess the need for treatment, 29,598 patients aged 40 years or older with open-angle glaucoma who started a statin after diagnosis were compared with an equal number of matched patients who had the same diagnosis and no record of statin use.
• Participants in the statin cohort had a documented use of atorvastatin, fluvastatin, lovastatin, pitavastatin, pravastatin, rosuvastatin, or simvastatin.
• Among adults without glaucoma, the primary outcome was a new diagnosis of open-angle glaucoma; among those with glaucoma, the outcomes were prescriptions for pressure-lowering eye drops, selective laser trabeculoplasty, minimally invasive glaucoma surgery, and incisional glaucoma surgery.

TAKEAWAY

• At 5 years, the use of statins was associated with a 15% lower risk of developing open-angle glaucoma. Among patients who already had glaucoma, the use of statins was associated with a 36% lower risk for incisional glaucoma surgery, a 55% lower risk for minimally invasive glaucoma surgery, a 60% lower risk for selective laser trabeculoplasty, and an 11% lower risk for a prescription for pressure-lowering eye drops.
• At 10 years, the use of statins was associated with a 10% lower risk of developing open-angle glaucoma. Among patients who already had glaucoma, the use of statins was associated with a 32% lower risk for incisional glaucoma surgery, a 46% lower risk for minimally invasive glaucoma surgery, a 51% lower risk for selective laser trabeculoplasty, and a 12% lower risk for a prescription for pressure-lowering eye drops.
• At 10 years, the use of atorvastatin was associated with a 17% lower risk of developing open-angle glaucoma and, in patients with the disease, with 33%-56% lower risks for surgery or laser treatment, with consistent results for rosuvastatin.

IN PRACTICE

"[The study] findings add to the growing literature surrounding the use of neuroprotective agents that complement ocular hypotensive medications or can be used independently of them to treat and prevent glaucoma," the researchers reported.

SOURCE

The study was led by Forest Lin, of the Morsani College of Medicine, University of South Florida in Tampa. It was published online on October 6 in the British Journal of Ophthalmology.

LIMITATIONS

The database did not include optic nerve scans, visual field and vision tests, or eye pressure readings, so the researchers could not gauge glaucoma severity or progression for individual patients. It also did not explain why patients had surgery or laser treatment, so some procedures may have been done for other reasons, such as not tolerating or not taking eye drops, rather than because the disease was worsening. The researchers also could not adjust for eye pressure, even though statins may have affected it. In addition, the analysis did not account for patients' use of eye drops to lower eye pressure, which can reduce glaucoma progression.

DISCLOSURES

The study received partial funding through an unrestricted grant from Research to Prevent Blindness. The authors reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.