Antithrombotic Medication and Incident Open-Angle Glaucoma

Marcus, Michael W.; Müskens, Rogier P.H.M.; Ramdas, Wishal D.; Wolfs, Roger C. W.; Jong, Paulus T. V. M. de; Vingerling, Johannes R.; Hofman, Albert; Stricker, Bruno H.; Jansonius, Nomdo M.

doi:10.1167/iovs.12-9604

Cited by 5 publications

(3 citation statements)

References 21 publications

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“…This is in keeping with the results of a randomized, crossover trial of aspirin versus placebo 32 and also in agreement with results from the Rotterdam Study, which reported that use of anticoagulants or platelet aggregation inhibitors was not associated with incident open-angle glaucoma 33 . The Rotterdam Study did report a nonsignificant trend towards lower IOP in participants taking aspirin (−0.21 mmHg; 95% CI, −0.44 to 0.01), although this was not adjusted for concurrent oral β-blocker use 33 …”

Section: Discussionsupporting

confidence: 89%

Systemic Medication and Intraocular Pressure in a British Population

Khawaja

Chan²,

Broadway

et al. 2014

Ophthalmology

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ObjectiveTo determine the association between systemic medication use and intraocular pressure (IOP) in a population of older British men and women.DesignPopulation-based, cross-sectional study.ParticipantsWe included 7093 participants from the European Prospective Investigation into Cancer–Norfolk Eye Study. Exclusion criteria were a history of glaucoma therapy (medical, laser, or surgical), IOP asymmetry between eyes of >5 mmHg, and missing data for any covariables. The mean age of participants was 68 years (range, 48–92) and 56% were women.MethodsWe measured IOP using the Ocular Response Analyzer. Three readings were taken per eye and the best signal value of the Goldmann-correlated IOP value considered. Participants were asked to bring all their medications and related documentation to the health examination, and these were recorded by the research nurse using an electronic case record form. The medication classes examined were angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, α-blockers, β-blockers, calcium channel blockers, diuretics, nitrates, statins, insulin, biguanides, sulfonylureas, aspirin, and other nonsteroidal anti-inflammatory drugs. We examined associations between medication use and IOP using multivariable linear regression models adjusted for age, sex, and body mass index. Models containing diabetic medication were further adjusted for glycosylated hemoglobin levels.Main Outcome MeasuresMean IOP of the right and left eyes.ResultsUse of systemic β-blockers (−0.92 mmHg; 95% CI, −1.19, −0.65; P<0.001) and nitrates (−0.63 mmHg; 95% CI, −1.12, −0.14; P = 0.011) were independently associated with lower IOP. The observed associations between statin or aspirin use with IOP were no longer significant after adjustment for β-blocker use.ConclusionsThis is the first population-based study to demonstrate and quantify clinically significant differences in IOP among participants using systemic β-blockers or nitrates. Lower IOP observed in participants using statins or aspirin was explained by concurrent systemic β-blocker use. The study findings may have implications for the management of glaucoma patients with comorbidity, and may provide insight into the pathophysiologic processes underlying IOP.

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Section: Discussionsupporting

confidence: 89%

Systemic Medication and Intraocular Pressure in a British Population

Khawaja

Chan²,

Broadway

et al. 2014

Ophthalmology

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“…Primary open-angle glaucoma (OAG) is a disease characterized by the irreversible loss of retinal ganglion cells, ultimately resulting in the loss of sight, 1 and it is a prevalent type of glaucoma in the Taiwanese population. 2 , 3 Statins act as selective inhibitors of HMG-CoA (3-hydroxy-3-methylglutaryl-coenzyme A) reductase and are widely used medications to lower cholesterol in patients with hyperlipidemia.…”

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confidence: 99%

Association Between Statin Use and Open-angle Glaucoma in Hyperlipidemia Patients

et al. 2015

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The aim of the study was to investigate the association between statin use and open-angle glaucoma (OAG) risk in hyperlipidemia patients.We used the research database of the Taiwan National Health Insurance program to conduct a population-based case-control study. A total of 1276 patients with newly diagnosed OAG were identified from 2004 to 2011. Controls comprised of 12,760 patients without glaucoma and were frequency-matched for age, sex, history of diabetes mellitus, and year of hyperlipidemia diagnosis at a 1:10 ratio. Accumulated defined daily doses (DDDs) of statins prescribed during follow-up were calculated. Average statin use was calculated as the sum of DDDs divided by the duration from the initial statin prescription date to the index date (per year), and was subdivided into 3 levels: <30, 30 to 119, and ≥120 DDDs. Comorbidity, including hypertension, depression, and the Charlson comorbidity index, the frequency of eye care visits, and the use of nonstatin cholesterol-lowering drugs, were all considered as confounding factors.For the group with statin use, the adjusted odds ratio of OAG was 1.02 (95% confidence interval 0.90–1.15) when compared with the group without statin use. Subanalysis showed that a high dosage of statin use (≥120 DDD/y) resulted in a1.24-fold increased risk of OAG (odds ratio 1.24, 95% confidence interval 1.03–1.49). The incidence of OAG was increased with the increase of the dosage of statin use (P for trend = 0.0458).Clinicians should be cautious of hyperlipidemia patients with a high dosage of statin use because it might be associated with an increased risk of OAG. Ophthalmologist consultation is necessary for this high-risk group.

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“…Transient myopia can also be caused by other drugs such as promethazine hydrochloride (Phenergan) [52], prochlorperazine (Compazine) [53], insulin [54][55][56][57], IGF1 and FGF2 [58], antithrombotic [59], opiate [60], tetracycline [15,61], aripiprazole [62,63], amisulpride [64], oseltamivir [65], mefenamic acid [66], ectasy [67], phendimetrazine and ephedrine used as anorexiants [68], equine antilymphocyte globulins [69], metronidazole [70], aspirine and deturgylone [71,72], isotretinoin (accutane) [3], isosorbide dinitrate [74], quinine [75].…”

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confidence: 99%

Transient Drug-Induced Myopia

Dkw¹

2014

SAJ Case Reports

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Myopia is the most common eye disease and is one of the leading causes of vision impairment worldwide [1,2]. Prevalence of myopia is significantly different among racial groups, although its worldwide prevalence is approximately 30% (3%-84%) [3]. The highest prevalence is found in East Asia, such as mainland China [3]. The prevalence of myopia in the US population was estimated in the early 1970s to be 25% in persons aged 12 to 54 years [4]. A recent meta-analysis of population-based studies found a prevalence of 25% in persons over age 40 [5].Myopia (nearsightedness) is a refractive error, a condition in which the cornea and lens of the nonaccommoding eye have too much plus power for the length of eye. As a result, images of distant objects are focused in front of the retina and thus appear blurred.Myopia has been recognized as a distinct visual disability for millennia and has been known for more than 2000 years and was first described by the ancient Greeks [6,7]. It was probably the ancient Greeks who coined the term, using the roots myein (to close) and ops (eye) to characterize those individuals who narrow their eyelids to improve distance visual acuity, the pinhole effect. The focus of distant parallel rays of light falls anterior to the retinal plane and produces a blurred image in myopia. This situation can arise because either the primary refractive components are too powerful or the globe is too long. Thus, myopia can be due to increased corneal or lenticular curvature, or an increase in the lens index of refraction, as occurs with the development of nuclear sclerosis. More commonly, myopia is the result of axial elongation of the posterior segment of the eye.Transient drug-induced myopia is a myopia induced by a drug as a transient side effect. A side effect (adverse drug reaction) is basically an unintended, unwanted occurrence that results from taking a drug. An adverse drug reaction is an expression that describes harm associated with the use of given medication at a normal dosage during normal use. Adverse drug reactions may occur following a single dose or prolonged administration of a drug or result from the combination of two or more drugs [8]. All drugs that come in the market may cause side effects, where many are minor and few are serious. Myopia (nearsightedness) is a refractive error, a condition in which the cornea and lens of the nonaccommoding eye have too much plus power for the length of eye. As a result, images of distant objects are focused in front of the retina and thus appear blurred. Transient drug-induced myopia is a myopia induced by a drug as a transient side effect. Several case reports of transient drug-induced myopia have been reported. These cases have been associated with secondary angle closure glaucoma and other ocular conditions such as choroidal detachment, maculopathy, retinal folds. Drugs known to produce this effect include sulfa drugs and other medications. The possible mechanism is thought to be an allergic reaction to the drug. Both ciliary muscle contraction a...

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Antithrombotic Medication and Incident Open-Angle Glaucoma

Abstract: Use of anticoagulants or platelet aggregation inhibitors appears not to be associated with incident OAG.

Cited by 5 publications

References 21 publications

Systemic Medication and Intraocular Pressure in a British Population

Systemic Medication and Intraocular Pressure in a British Population

Association Between Statin Use and Open-angle Glaucoma in Hyperlipidemia Patients

Transient Drug-Induced Myopia

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