Statin Use in Relation to Intraocular Pressure, Glaucoma, and Ocular Coherence Tomography Parameters in the UK Biobank

Abstract

Purpose The purpose of this study was to evaluate the relationship between statin use and glaucoma-related traits. Methods In a cross-sectional study, we included 118,153 UK Biobank participants with data on statin use and corneal-compensated IOP. In addition, we included 192,283 participants (8982 cases) with data on glaucoma status. After excluding participants with neurodegenerative diseases, 41,638 participants with macular retinal nerve fiber layer thickness (mRNFL) and 41,547 participants with macular ganglion cell inner plexiform layer thickness (mGCIPL) were available for analysis. We examined associations of statin use with IOP, mRNFL, mGCIPL, and glaucoma status utilizing multivariable-adjusted regression models. We assessed whether a glaucoma polygenic risk score (PRS) modified associations. We performed Mendelian randomization (MR) experiments to investigate associations with various glaucoma-related outcomes. Results Statin users had higher unadjusted mean IOP ± SD than nonusers, but in a multivariable-adjusted model, IOP did not differ by statin use (difference = 0.05 mm Hg, 95% confidence interval [CI] = −0.02 to 0.13, P = 0.17). Similarly, statin use was not associated with prevalent glaucoma (odds ratio [OR] = 1.05, 95% CI = 0.98 to 1.13). Statin use was weakly associated with thinner mRNFL (difference = −0.15 microns, 95% CI = −0.28 to −0.01, P = 0.03) but not with mGCIPL thickness (difference = −0.12 microns, 95% CI = −0.29 to 0.05, P = 0.17). No association was modified by the glaucoma PRS ( P interaction ≥ 0.16). MR experiments showed no evidence for a causal association between the cholesterol-altering effect of statins and several glaucoma traits (inverse weighted variance P ≥ 0.14). Conclusions We found no evidence of a protective association between statin use and glaucoma or related traits after adjusting for key confounders.

Metabolite and Lipid Biomarkers Associated With Intraocular Pressure and Inner Retinal Morphology: 1H NMR Spectroscopy Results From the UK Biobank

“…A large study from the UK Biobank showed that current statin use was associated with borderline lower IOP (−0.6 mm Hg; P = 0.10) but with additional controls for total cholesterol and triglycerides, the association became borderline adverse (+0.05 mm Hg; P = 0.17). 35 In addition, statin users had thinner mRNFL in a multivariable model that included adjustment for plasma total cholesterol and triglyceride levels (−0.14 microns; P = 0.03). 35 Recent studies suggest that statins are not protective for patients with glaucoma, 35 – 38 perhaps because their effects on IOP are nominal.…”

“… 35 In addition, statin users had thinner mRNFL in a multivariable model that included adjustment for plasma total cholesterol and triglyceride levels (−0.14 microns; P = 0.03). 35 Recent studies suggest that statins are not protective for patients with glaucoma, 35 – 38 perhaps because their effects on IOP are nominal. Furthermore, in our MESA analysis, various LDL subtypes were not associated with IOP, but they were associated with thicker mGCIPL and thicker mRNFL (see Figs.…”

Internistische Erkrankungen und Zusammenhang mit dem primären Offenwinkelglaukom

“…These results are reflected in partially contradictory findings in the literature, and only a few studies have considered polypharmacy, such as the simultaneous use of statins and βblockers in cardiovascular diseases. Recent studies taking this into account have no longer been able to demonstrate a correlation between the use of statins and the risk of glaucoma [69].…”

“…die gleichzeitige Einnahme von Statinen und Betablockern bei kardiovaskulären Erkrankungen. Neuere, dies berücksichtigende Studien konnten keinen Zusammenhang zwischen der Einnahme von Statinen und dem Glaukomrisiko mehr nachweisen [69].…”

Regulatory role of cholesterol in modulating actin dynamics and cell adhesive interactions in the trabecular meshwork

“…Our recent work provided evidence that the inactivation of the transcription factors sterol regulatory element binding proteins (SREBPs), involved in fatty acid and cholesterol biogenesis, significantly lowered intraocular pressure (7). Moreover, studies found that the use of statins, cholesterol biosynthesis inhibitors, can reduce the incidence and progression of glaucoma (8)(9)(10)(11)(12) in spite of some inconsistencies regarding the role of cholesterol in POAG pathogenesis (13). Although cholesterol is related to glaucoma pathogenesis and IOP elevation, the causal effects of cholesterol in IOP elevation and glaucoma progression are not fully understood.…”