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 Glaucoma is a group of eye conditions that can damage the optic
nerve, typically because pressure builds up inside the eye. The
current study focused on the most common form, known as open-angle
glaucoma, which starts with gradual loss of peripheral vision.
Researchers followed more than 136,000 healthy adults for over a
decade, starting when they were 40 years old and had no signs of
glaucoma. By the end of the study, 886 glaucoma cases were
diagnosed.
People with any history of high cholesterol were 17 percent more
likely to develop glaucoma, researchers report in JAMA
Ophthalmology. And every 20 milligrams per deciliter of blood
increase in total cholesterol was tied to a 7 percent increase in
glaucoma risk.
In contrast, any statin use was associated with a 15 percent lower
risk of glaucoma overall, the study found. And people who took
statins for five or more years were 21 percent less likely to
develop glaucoma than those who had never used the drugs.
"The potential mechanisms by which statins may lower the risk of
primary open-angle glaucoma is by lowering intraocular pressure,
which is a glaucoma risk factor; by helping to maintain adequate
blood flow to the optic nerve and by strengthening neuroprotective
mechanisms," said lead study author Jae Hee Kang of Brigham and
Women's Hospital and Harvard Medical School in Boston.
"The relation with high cholesterol is not well understood but may
be related to impaired blood flow to the optic nerve or to the
exacerbation of neurodegenerative processes with aging," Kang said
by email.
Statins are typically prescribed to people with high cholesterol or
a high risk for heart attacks or strokes. Side effects can include
muscle pain, liver damage, upset stomach, elevated blood sugar and
memory problems.
To explore the connection between statins and glaucoma, researchers
examined data from three long-term studies of U.S. nurses and health
professionals. All participants had regular eye exams and were
periodically assessed for statin use or diagnosis of high
cholesterol.
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Among people who never used statins, 34 to 56 percent had high
cholesterol.
High cholesterol was even more common among statin users, affecting
84 to 94 percent of people on the pills for up to two years and 96
to 99 percent of patients on statins for at least five years.
The effect of statins on glaucoma risk was most pronounced in older
participants. People over 65 who used statins for at least five
years were 30 percent less likely to develop glaucoma than
individuals who never used these drugs, while people under 65 saw no
risk reduction.
One limitation of the study is that researchers relied on
participants to accurately recall and report any statin use or
diagnosis of high cholesterol. Results from a study of predominantly
white health professionals also may not reflect what would happen in
other groups of people.
Even so, the results highlight the need for further research to
explore whether statins might one day be prescribed to prevent
glaucoma, which is not currently an approved use of these pills,
said the co-author of an accompanying editorial, Dr. Yao Liu of the
University of Wisconsin-Madison
"This study is important because glaucoma is a serious eye condition
that can cause permanent vision loss" and for which there's no cure,
Liu said by email.
"The only way we currently know how to prevent glaucoma damage is by
lowering eye pressure (using medications, laser or surgery), but
some patients continue to lose vision despite lowering their eye
pressure," Liu said. "New treatments to prevent glaucoma are needed
to prevent vision loss and preserve patients' quality of life."
SOURCE: https://bit.ly/2YeQ3kI and https://bit.ly/2VN3Dyn JAMA
Ophthalmology, online May 2, 2019.
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