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Long-Term Use of Statins May Protect Against Glaucoma

Long-term statin use may be associated with a reduced risk of glaucoma, according to a nested case-control study.

Paul P. Lee, MD, JD, Duke Eye Center, Durham, North Carolina, United States, and colleagues used administrative clinical databases from the Veterans Affairs Medical Center, in Birmingham, Alabama to identify 667 male patients, aged 50 years and older, with a new diagnosis of glaucoma, and 6667 age matched controls without glaucoma. The investigators identified comorbid medical conditions and prescriptions for statins, including atorvastatin calcium, cerivastatin sodium, fluvastatin sodium, pravastatin sodium, simvastatin, and lovastatin, as well as for nonstatin lipid-lowering agents in the cases and controls.

The mean age of the patient population was 69 years, 170 of cases had open-angle glaucoma, 31 had other specified forms of glaucoma, and 466 had unspecified glaucoma. Cases were more likely to have diabetes, lipid metabolism disorders, and hypertension than controls.

After adjusting for diabetes, lipid metabolism disorders, hypertension, cardiovascular disease, cerebrovascular disease, and arterial disease, statin use appears protective against glaucoma, odds ratio (OR) 0.85. Past statin use appears more protective with an OR of 0.74 compared with current statin use with an OR of 0.94. Longer-term statin use trended towards a reduced risk of glaucoma, with statin use for more than 23 months being associated with a reduced risk of open-angle glaucoma, OR 0.60.

Statins also appear protective among patients with lipid metabolism disorders and cardiovascular disease, OR 0.63 for both, as well as among patients without cerebrovascular disease, OR 0.76, after adjusting for other comorbid conditions.

The use of nonstatin lipid-lowering medications was also protective against glaucoma, OR 0.59. However, this association appeared reserved to those who used nonstatin lipid-lowering medications for less than 12 months, OR 0.38.

Analysis of the joint effect of statin and nonstatin therapies revealed an OR of 0.52 for both types of medications, of 0.60 for non statin use only, and of 0.86 for statin use only, but none of these associations was statistically significant.

"The results of the current study thus suggest that the association between statin use and the risk of glaucoma deserves further investigation," the authors conclude.


Arch Ophthalmol 2004;122:822-826

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