Do statins reduce the risk of glaucoma? review of the evidences

Authors

DOI:

https://doi.org/10.30827/ars.v62i4.21463

Keywords:

statins; hmg coa inhibitors; glaucoma

Abstract

Introduction: The objectives of this article are to review and summarize the updated published data that show the relation between treatment with statins and the incidence and progression of glaucoma. We also aimed to pose a hypothesis to explain the protective effects of statins and its association with glaucoma risk.

Method: a review of the literature was carried out in the PubMed database considering the MeSH terms “statins, hmg coa” or “hmg coa inhibitors” and “glaucoma” or “open angle glaucoma” or “intraocular pressure”. All articles including clinical studies and meta-analysis were selected. Comments, letters to editors, retracted articles and research on animal models were excluded. All the articles were published from 2004. 17 articles were finally selected for review.

Results: most of the studies showed a protective effect of statins on incidence or progression of open angle glaucoma. Nevertheless, other studies did not find a significant association and even one study found association between statin treatment at high doses and more incidence of glaucoma. Neuroprotective effects of statin and inhibition of Rho-kinase may help explain the described effects.

Conclusions: The published results are not enough evidence to support statin recommendation as preventive treatment for the incidence or progression of glaucoma.

Downloads

References

Schmeer C, Kretz A, Isenmann S. Therapeutic potential of 3-hydroxy-3-methylglutaryl coenzyme a reductase inhibitors for the treatment of retinal and eye diseases. CNS Neurol Disord Drug Targets. 2007; 6(4): 282-287. DOI: 10.2174/187152707781387260

Stein JD, Newman-Casey PA, Talwar N, Nan B, Richards JE, Musch DC. The relationship between statin use and open-angle glaucoma. Ophthalmology. 2012; 119(10): 2074-2081. DOI: 10.1016/j.ophtha.2012.04.029

Ritter JM, Flower R, Henderson G, Loke YK, MacEwan D, Rang HP. Ateroesclerosis y metabolismo lipoproteico. En: Rang HP, Dale MM, Ritter JM, Flower RJ, Henderson G, editores. Farmacología. 9ª ed. Barcelona: Elsevier; 2020. p.310-318.

Villarreal G Jr, Chatterjee A, Oh SS, Oh DJ, Rhee DJ. Pharmacological regulation of SPARC by lovastatin in human trabecular meshwork cells. Invest Ophthalmol Vis Sci. 2014; 55(3): 1657-1665. DOI: 10.1167/iovs.13-12712

Oesterle A, Laufs U, Liao JK. Pleiotropic effects of statins on cardiovascular system. Circ Res 2017;120 (1): 229-243. DOI: 10.1161/CIRCRESAHA.116.308537

Rao PV, Deng PF, Kumar J, Epstein DL. Modulation of aqueous humor outflow facility by the Rho kinase-specific Inhibitor Y-27632. Invest Ophthalmol Vis Sci. 2001; 42(5):1029-1037.

Martín PY, Piloto DI, Álvarez CG, Fumero GF, Rodríguez RD, Sánchez AL. Fisiología trabecular y glaucoma de ángulo abierto. Rev Cuba Oftalmol. 2012; 25(3): 458-466.

Tham YC, Li X, Wong TY, Quigley HA, Aung T, Cheng CY. Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology. 2014; 121:2081–2090. DOI: 10.1016/j.ophtha.2014.05.013

Olson EA, Hainsworth DP, Davis G, Hagan JC. Eye on statins: a comprehensive review. Mo Med. 2013; 110(4): 344-348.

Wierzbowska J, Robaszkiewicz J, Figurska M, Stankiewicz A. Future possibilities in glaucoma therapy. Med Sci Monit. 2010; 16(11): 252-259.

Nagaoka T, Takahashi A, Sato E et al. Effect of systemic administration of simvastatin on retinal circulation. Arch Ophthalmol. 2006;124(5):665-70. DOI: 10.1001/archopht.124.5.665

McCann P, Hogg RE, Fallis R, Azuara-Blanco A. The effect of statins on intraocular pressure and on the incidence and progression of glaucoma: a systematic review and meta-analysis. Invest Ophthalmol Vis Sci. 2016; 57(6): 2729-2748. DOI: 10.1167/iovs.15-18595

De Castro DK, Punjabi OS, Bostrom AG et al. Effect of statin drugs and aspirin on progression in open-angle glaucoma suspects using confocal scanning laser ophthalmoscopy. Clin Experiment Ophthalmol. 2007; 35: 506-513. DOI: 10.1111/j.1442-9071.2007.01529.x

Iskedjian M, Walker JH, Desjardins O et al. Effect of selected antihypertensives, antidiabetics, statins and diuretics on adjunctive medical treatment of glaucoma: a population based study. Curr Med Res Opin. 2009; 25(8): 1879-1888. DOI: 10.1185/03007990903035083.

Owen CG, Carey IM, Shah S, et al. Hypotensive medication, statins, and the risk of glaucoma. Invest Ophthalmol Vis Sci. 2010; 51(7): 3524-3530. DOI: 10.1167/iovs.09-4821

Khawaja AP, Chan MP, Broadway DC et al. Systemic medication and intraocular pressure in a British population: the EPIC-Norfolk Eye Study. Ophthalmology. 2014; 121: 1501-1507. DOI: 10.1016/j.ophtha.2014.02.009

Ho H, Shi Y, Chua J, et al. Association of systemic medication use with intraocular pressure in a multiethnic asian population: The Singapore Epidemiology of Eye Diseases Study. JAMA Ophthalmol. 2017;135(3):196-202. DOI: 10.1001/jamaophthalmol.2016.5318

Pappelis K, Loiselle AR, Visser S, Jansonius NM. Association of Systemic Medication Exposure With Glaucoma Progression and Glaucoma Suspect Conversion in the Groningen Longitudinal Glaucoma Study. Invest Ophthalmol Vis Sci. 2019;60(14):4548-4555. DOI: 10.1167/iovs.19-27984

McGwin G, McNeal S, Owsley C, Girkin C, Epstein D, Lee PP. Statins and other cholesterol-lowering medications and the presence of glaucoma. Arch Ophthalmol. 2004; 122: 822-826. DOI: 10.1001/archopht.122.6.822

Artes PH, Chauhan BC. Longitudinal changes in the visual field and optic disc in glaucoma. Prog Retin Eye Res 2005; 24: 333–354. DOI: 10.1016/j.preteyeres.2004.10.002

Leung DY, Li FC, Kwong YY, Tham CC, Chi SC, Lam DS. Simvastatin and disease stabilization in normal tension glaucoma: a cohort study. Ophthalmology. 2010; 117: 471-476. DOI: 10.1016/j.ophtha.2009.08.016

Marcus MW, Müskens RP, Ramdas WD, et al. Cholesterol-lowering drugs and incident open-angle glaucoma: a population-based cohort study. PLoS ONE. 2012; 7(1): e29724.

Talwar N, Musch DC, Stein JD. Association of daily dosage and type of statin agent with risk of open-angle glaucoma. JAMA Ophthalmol. 2017; 135(3): 263-67. DOI: 10.1371/journal.pone.0029724

Whigham B, Oddone EZ, Woolson S, et al. The influence of oral statin medications on progression of glaucomatous visual field loss: A propensity score analysis. Ophthalmic Epidemiol. 2018;25(3):207-214. DOI: 10.1080/09286586.2017.1399427

Ooba N, Iwahashi R, Nogami A, et al. Comparison between high and low potency statins in the incidence of open-angle glaucoma: A retrospective cohort study in Japanese working-age population. PLoS One 2020;15(8):e0237617. DOI: 10.1371/journal.pone.0237617

Shon K, Sung KR. Dyslipidemia, dyslipidemia treatment, and open-angle glaucoma in the Korean national health and nutrition examination survey. J Glaucoma 2019; 28(6): 550-556. DOI: 10.1097/IJG.0000000000001237

Chen HY, Hsu SY, Chang YC, et al. Association between statin use and open-angle glaucoma in hyperlipidemia patients: a Taiwanese population-based case-control study. Medicine. 2015; 94(45): e2018. DOI: 10.1097/MD.0000000000002018

Zacco A, Togo J, Spence K, et al. 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors protect cortical neurons from excitotoxicity. J Neurosci 2003; 23: 11104–11111. DOI: 10.1523/JNEUROSCI.23-35-11104.2003

Bösel J, Gandor F, Harms C, et al. Neuroprotective effects of atorvastatin against glutamate-induced excitotoxicity in primary cortical neurones. J Neurochem. 2005; 92(6): 1386-1398. DOI: 10.1111/j.1471-4159.2004.02980.x

Honjo M, Tanihara H, Nishijima K, et al. Statin inhibits leukocyte-endothelial interaction and prevents neuronal death induced by ischemia-reperfusion injury in the rat retina. Arch Ophthalmol. 2002; 120:1707–1713. DOI: 10.1001/archopht.120.12.1707

Song J, Deng PF, Stinnett SS, Epstein DL, Rao PV. Effects of cholesterol-lowering statins on the aqueous humor outflow pathway. Invest Ophthalmol Vis Sci. 2005; 46(7):2424-2432. DOI: 10.1167/iovs.04-0776

Kotikoski H, Oksala O, Vapaatalo H, Aine E. Aqueous humour flow after a single oral dose of isosorbide-5-mononitrate in healthy volunteers. Acta Ophthalmol Scand. 2003; 81(4): 355-360. DOI: 10.1034/j.1600-0420.2003.00109.x

Published

2021-09-20

How to Cite

1.
Alvarez de Sotomayor M, Pastor L. Do statins reduce the risk of glaucoma? review of the evidences. Ars Pharm [Internet]. 2021 Sep. 20 [cited 2025 Apr. 8];62(4):419-37. Available from: https://revistaseug.ugr.es/index.php/ars/article/view/21463

Issue

Section

Review Articles