In Brief | Ophthalmology | Glaucoma

Association of Systemic Medication Use with Glaucoma and Intraocular Pressure 

Time to read: 01:50

Original Published In Opthalmology: September 2023. This summary does not represent the original research, nor is it intended to replace the original research. Content Disclaimer

As populations age worldwide, it becomes increasingly important to manage the range of concomitant diseases such as hypotension, diabetes, and other cardio- and neuro-vascular conditions. Glaucoma, one of the leading causes of visual impairment in older people, is one such condition.
 

In this recent study, published in Ophthalmology, researchers set out to determine which, if any, of the more commonly prescribed systemic medications was associated with an increased risk for developing raised intraocular pressure and glaucoma. Given that intraocular pressure is the only modifiable factor in the development of glaucoma, the results of this study could potentially assist in the development of alternative treatment protocols for patients.  

The study, a metanalysis, was conducted on 140,000 participants selected from 11 population cohort studies from 8 countries across Europe:

• Glaucoma analysis was conducted on 143 240 participants,

• IOP analyses on 47 177 participants

 

The study included the following drug categories: antihypertensive medications (β-blockers, diuretics, calcium channel blockers [CCBs], α-agonists, angiotensin-converting enzyme inhibitors, and angiotensin II receptor blockers), lipid-lowering medications, antidepressants, and antidiabetic medications.

 

The researchers recorded the following results: 

Glaucoma:

• The use of CCBs was associated with a higher prevalence of glaucoma (odds ratio 1.23; 95% confidence interval, 1.08 to 1.39)

• This association was stronger for monotherapy of CCBs with direct cardiac effects  (odd ratio, 1.96; 95% confidence interval 1.23 to 3.12).

• No other antihypertensive, lipid-lowering, antidepressants or antidiabetic medications were associated with glaucoma. 

 

Intraocular Pressure:

• The use of systemic β-blockers was associated with a lower IOP (β coefficient, −0.33 mmHg; 95% CI, −0.57 to −0.08 mmHg). 

• Monotherapy of both selective systemic β-blockers and nonselective systemic β-blockers was associated with lower IOP. 

• A suggestive association was found between the use of high-ceiling diuretics and lower IOP but not when used as monotherapy. 

• No other antihypertensive, lipid-lowering, antidepressants or antidiabetic medications were associated with IOP.

 

The researchers note that the study's limitation was the use of the meta-analysis approach, which may have limited the sample group's heterogeneity. Nonetheless, the results were sufficiently robust to indicate the potentially harmful association of CCBs with the increased risk of glaucoma, particularly given the frequent use of these medications in this sample group. 

 

Access the original article 
 

1. Vergroesen, J. E., Schuster, A. K., Stuart, K. V., Asefa, N. G., Cougnard-Grégoire, A., Delcourt, C., Schweitzer, C., Barreto, P., Coimbra, R., Foster, P. J., Luben, R. N., Pfeiffer, N., Stingl, J. V., Kirsten, T., Rauscher, F. G., Wirkner, K., Jansonius, N. M., Arnould, L., Creuzot-Garcher, C. P., Stricker, B. H., … European Eye Epidemiology Consortium (2023). Association of Systemic Medication Use with Glaucoma and Intraocular Pressure: The European Eye Epidemiology Consortium. Ophthalmology, 130(9), 893–906. https://doi.org/10.1016/j.ophtha.2023.05.001  

 

Back to top

---

Disclaimer
This article is compiled from a variety of resources researched and compiled by the contributor. It is in no way presented as an original work.  Every effort has been made to attribute quotes and content correctly. Where possible all information has been independently verified. The Medical Education Network bears no responsibility for any inaccuracies which may occur from the use of third-party sources. If you have any queries regarding this article contact us 

Fact-checking Policy
The Medical Education Network makes every effort to review and fact-check the articles used as source material in our summaries and original material. We have strict guidelines in relation to the publications we use as our source data, favouring peer-reviewed research wherever possible. Every effort is made to ensure that the information contained here is an accurate reflection of the original material. Should you find inaccuracies, out of date content or have any additional issues with our articles, please make use of the contact us form to notify us.