STATINS AND GLAUCOMA

By Dr. Kevin -

 A large retrospective cohort study published in the British Journal of Ophthalmology suggests that long-term statin use may reduce both the risk of developing open-angle glaucoma (OAG) and the need for subsequent treatment escalation. 

Key Findings

  • Reduced Incidence: Statin users showed a 15% lower risk of developing OAG at 5 years and a 10% lower risk at 10 years.

  • Lower Risk of Treatment Escalation: Among patients with existing OAG (n = 29,598 per group), 5-year statin use was associated with:

    • 60% lower risk of selective laser trabeculoplasty (SLT)

    • 55% lower risk of minimally invasive glaucoma surgery (MIGS)

    • 36% lower risk of traditional incisional glaucoma surgery

    • 11% lower risk of needing additional topical ocular hypotensive prescriptions

  • Sustained Benefit: These protective associations persisted through 10 years of follow-up, though the magnitude of effect slightly decreased over time.

Potential Mechanisms & Limitations

Researchers suggest statins may benefit glaucoma patients through neuroprotective, anti-inflammatory, and vascular mechanisms—including improved retinal blood flow, reduced oxidative stress, and enhanced aqueous humor outflow via the trabecular meshwork. However, because the study relied on administrative database entries, it lacked clinical measurements like intraocular pressure (IOP), visual field progression, and optic nerve imaging, making prospective randomized clinical trials necessary to confirm a direct causal relationship.

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