Abstract
BackgroundOpen-angle glaucoma (OAG) is a progressive neurodegenerative disease that may lead to blindness. An elevated intraocular pressure (IOP) is its major risk factor. OAG treatment is currently exclusively directed towards the lowering of the IOP. IOP lowering does not prevent disease progression in all patients and thus other treatment modalities are needed. Earlier studies reported cholesterol-lowering drugs to have neuroprotective properties. The aim of this study was to determine the associations between the use of cholesterol-lowering drugs and incident OAG.Methodology/Principal FindingsParticipants in a prospective population-based cohort study underwent ophthalmic examinations, including IOP measurements and perimetry, at baseline and follow-up. The use of statins and non-statin cholesterol-lowering drugs was monitored continuously during the study. Associations between the use of cholesterol-lowering drugs and incident OAG were analyzed with Cox regression; associations between cholesterol-lowering drugs and IOP at follow-up were analyzed with multiple linear regression. During a mean follow-up of 9.8 years, 108 of 3939 eligible participants (2.7%) developed OAG. The hazard ratio for statin use was 0.54 (95% confidence interval 0.31–0.96; P = 0.034) and for non-statin cholesterol-lowering drugs 2.07 (0.81–5.33; P = 0.13). The effect of statins was more pronounced with prolonged use (hazard ratio 0.89 [0.41–1.94; P = 0.77] for use two years or less; 0.46 [0.23–0.94; P = 0.033] for use more than two years; P-value for trend 0.10). The analyzes were adjusted for age and gender, baseline IOP and IOP-lowering treatment, the family history of glaucoma, and myopia. There was no effect of statins on the IOP.Conclusions/SignificanceLong-term use of statins appears to be associated with a reduced risk of OAG. The observed effect was independent of the IOP. These findings are in line with the idea that statins have neuroprotective properties and may open a way to a new OAG treatment modality.
Highlights
Open-angle glaucoma (OAG) is a progressive neurodegenerative disease that leads to glaucomatous optic neuropathy and eventually, through glaucomatous visual field loss, to loss of sight
As can be seen in this table, there was no significant intraocular pressure (IOP)-lowering effect of statins. In this large prospective population-based study, the use of statins was associated with a reduced risk of OAG
The use of non-statin cholesterol-lowering drugs (NSCLDs) was not associated with the development of OAG
Summary
Open-angle glaucoma (OAG) is a progressive neurodegenerative disease that leads to glaucomatous optic neuropathy and eventually, through glaucomatous visual field loss, to loss of sight. Statins are selective inhibitors of 3-hydroxyl-3-methylglutaryl coenzyme A reductase (HMG-CoA) [1] They are the most important lipid lowering medications for the treatment of hypercholesterolemia [2,3,4]. With the current recommendations of lower primary prevention thresholds [23,24], the use of statins and NSCLDs has increased markedly over the years [25]. For these reasons, it is expedient to clarify the associations between these drugs and OAG.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
