STATIN USE AND GLAUCOMA

 

DR. MOHSINA

P.G. SCHOLAR

DEPARTMENT OF ANATOMY

STATE TAKMEEL-UT-TIB COLLEGE & HOSPITAL

LUCKNOW, INDIA

Cholesterol is the principal sterol of all higher animals, distributed in body tissues, especially the brain and spinal cord, and in animal fats and oils. Elevated cholesterol in the blood, especially when bound to low-density lipoprotein (LDL, often called "bad cholesterol"), may increase the risk of cardiovascular disease.

Statins are a group of medicines that reduce the production of low-density lipoprotein (LDL) cholesterol in the liver, thus lowering blood cholesterol levels.

Statins are usually used to lower blood cholesterol levels and reduce the risk for atherosclerosis-related illnesses, such as cardiovascular disease. 

Statins have been suggested to increase retinal and choroidal blood flow, protect retinal ganglion cells in the setting of ischemia, and lower IOP, and they have been investigated as neuroprotective agents outside their primary indication as anti-hypercholesterolemic agents.

A study was performed by Lee and associates to investigate the association between statin use and glaucoma in the 2017-2022 All of Us (AoU) Research Program of the National Institute of Health (NIH), USA.

The cross-sectional, population-based study involved 79,742 adult participants aged ≥ 40 years with hyperlipidemia enrolled in the AoU database.

Of the 79,742 individuals with hyperlipidemia in AoU, there were 6,365 (8.0%) statin users.

Statin use was associated with increased glaucoma prevalence when compared with statin non-use (adjusted odds ratio [aOR]: 1.13, 95% confidence interval [CI]: 1.01-1.26).

Higher serum levels of LDL were associated with increased odds of glaucoma (aOR: 1.003, 95% CI: 1.003, 1.004).

Statin users had significantly higher LDL levels in comparison to the nonusers (144.9 mg/dL versus 136.3 mg/dL, p-value < 0.001).

Analysis stratified by LDL identified positive associations between statin use and prevalence of glaucoma among those with optimal (aOR = 1.39, 95% CI = 1.05-1.82) and high (aOR = 1.37, 95% CI = 1.09-1.70) LDL levels.

Age-stratified analysis showed a positive association between statin use and the prevalence of glaucoma in individuals aged 60-69 years (aOR = 1.28, 95% CI = 1.05-1.56).

CONCLUSIONS:

The study concluded that statin use was associated with increased glaucoma likelihood in the overall adult AoU population with hyperlipidemia, in individuals with optimal or high LDL levels, and individuals 60-69 years old. Findings suggest that statin use may be an independent risk factor for glaucoma, which may furthermore be affected by one’s lipid profile and age.

REFERENCE:

Lee SY, Paul ME, Coleman AL, Kitayama K, Yu F, Pan D, Tseng VL. Associations between Statin Use and Glaucoma in the All of Us Research Program. Ophthalmol Glaucoma. 2024 Jul 31:S2589-4196(24)00137-6. doi: 10.1016/j.ogla.2024.07.008. Epub ahead of print. PMID: 39094953.