Overactive bladder and glaucoma: a survey at outpatient clinics in Japan

To determine the prevalence of a history of glaucoma and the relative safety of prescribing anticholinergics to patients with overactive bladder (OAB).

Between 2003 and 2005, 267 female OAB patients (mean age, 65.8 years) and 100 male OAB patients (mean age, 73.0 years) were directly asked about their history of glaucoma. Those with a positive history were referred to ophthalmologists to differentiate types of glaucoma.

For direct history taking, 31 (11.6%) of the female OAB patients and five (5.0%) of the male OAB patients admitted their history of glaucoma. Referrals to ophthalmologists revealed that 27 had open-angle glaucoma and nine had angle-closure glaucoma. Six of the patients with angle-closure glaucoma had already received laser iridotomy, and the remaining three (8.3% of patients with coexisting glaucoma) were diagnosed as true contraindications for anticholinergics.

As both OAB and glaucoma increase with age, it is not surprising that approximately 10% of OAB patients have glaucoma. Although the majority have had either open-angle glaucoma or angle-closure glaucoma already treated, some of them may be true contraindications for anticholinergics due to uncontrolled angle-closure glaucoma. It seems necessary to treat OAB patients based on accurate information on the relationship between glaucoma and anticholinergics.