Statin users less likely to need stronger treatment for glaucoma

By Stephen Beech

Statins may protect people from developing an eye condition that can lead to blindness, suggests new research.

Patients with glaucoma who take the cholesterol-busting pills appear less likely to need surgery — and have a reduced chance of it getting worse, according to the findings.

Glaucoma is a group of eye diseases that may lead to damage of the optic nerve, which transmits visual information from the eye to the brain.

Called the "silent thief of sight" because the loss of vision usually occurs slowly over a long period of time, glaucoma may cause vision loss if left untreated.

But a new American study, published online in the British Journal of Ophthalmology, found that people who already have glaucoma who are taking statins appear less likely to need stronger treatments such as extra eye drops or surgery to keep it under control.

Study author Dr. Robert Weinreb said: "Glaucoma, a leading cause of irreversible blindness, is caused by permanent damage to the optic nerve.

"Statins are prescribed to lower cholesterol levels but studies have indicated that they may also prevent or slow nerve cell death.

"Their potential role in preventing or slowing down glaucoma is poorly understood."

Weinreb and his team searched a large global database covering 165 million people.

They compared more than 210,000 people who had a record of statin use between August 2006 and August 2026 with a matched control group of 210,000 people who had no record of using statins.

People in both groups had to have a recorded ophthalmological follow-up.

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Statin use was associated with a 15% lower risk of developing open-angle glaucoma, according to the findings.

After five years, there were 4,771 new diagnoses of glaucoma in the statin group (2.3%) and 5,491 in the control group (2.6%).

In a separate analysis, more than 30,000 people with glaucoma who were taking statins were compared with almost 250,000 with glaucoma who weren't taking the drug.

Weinreb, from the University of California, San Diego, said: "Statins were linked to a lower risk of the individual progressing to need glaucoma surgery or other treatment.

"At five years, statin use was associated with a 36% lower risk of incisional glaucoma surgery and a 55% reduced risk of minimally invasive glaucoma surgery (MIGS) — a keyhole procedure to lower the intraocular pressure in the eye.

"Statins were also associated with a 60% lower risk of selective laser trabeculoplasty (SLT) — a procedure that lowers the pressure in the eye by using laser pulses.

"There was also a 12% reduced risk of eye drops to reduce the pressure in the eye linked to statin use."

The study shows that, after 10 years, statin use continued to be associated with a lower risk of incision glaucoma surgery, MIGS, SLT and use of eye drops.

Weinreb said it was an observational study and as such, no firm conclusions can be drawn about cause and effect.

But he says the findings add to the growing literature about the neuroprotective effect of statins.

Weinreb added: "Our findings suggest that statin usage is associated with both lower incidence of primary open-angle glaucoma as well as decreased treatment escalation."

He says randomized trials are now needed to better understand the effects of statin use on glaucoma incidence and treatment.