Systemic Medication Associations with Presumed Advanced or Uncontrolled Primary Open-Angle Glaucoma.

Area of Science:

• Ophthalmology
• Pharmacology
• Epidemiology

Background:

• Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness worldwide.
• Identifying modifiable risk factors, including systemic medications, is crucial for POAG prevention and management.
• Understanding drug associations can inform clinical practice and future research directions.

Purpose of the Study:

• To investigate potential associations between systemic medication use and the occurrence of primary open-angle glaucoma (POAG) requiring surgical intervention.
• To generate hypotheses regarding drug classes and specific agents linked to POAG risk using a large-scale claims database.

Main Methods:

• A retrospective database study utilizing United States insurance claims data.
• Matched 6130 POAG cases with 30,650 controls based on age, gender, and region.
• Employed logistic regression to analyze prescription drug use in the 5 years preceding the index procedure, adjusting for multiple covariates.

Main Results:

• Selective serotonin reuptake inhibitors (SSRIs) demonstrated a significant association with reduced POAG risk (OR, 0.70; P < 1.0 × 10⁻¹⁵), with citalopram being the most notable.
• Calcium channel blockers (CCBs) were associated with an increased risk of POAG (OR, 1.26; P < 1.8 × 10⁻¹¹), with amlodipine showing the strongest effect.

Conclusions:

• The study identified potential associations between SSRIs and reduced POAG risk, and CCBs and increased POAG risk.
• These findings warrant further investigation into the roles of serotonin pathways and calcium channels in glaucoma pathogenesis.
• Exploring prescribing pattern variations may also elucidate these observed associations.