Association Between Statin Use and Glaucoma Risk: A Population-Based Study

To investigate the association between statin use and glaucoma risk.

This is a nationwide nested case-control study including adults with hyperlipidemia from the Taiwan National Health Insurance Research Database between 2009 and 2020. Cases were individuals newly diagnosed with ocular hypertension, primary open-angle glaucoma (POAG), or normal tension glaucoma (NTG). Controls were individuals without any subtypes of glaucoma. Prescription records for statins, fibrates, and other cholesterol-lowering medications were collected. Logistic regression models were applied to assess the association between medication exposure and the risk of glaucoma.

The final analysis included 32,640 participants with ocular hypertension, 20,390 with POAG, 9945 with NTG, and more than 130,560 in the control group. Compared to non-users, statin users had significantly higher risks of developing ocular hypertension (adjusted odds ratio [aOR] = 1.12; 95% confidence interval [CI], 1.09-1.15; P < 0.001) and POAG (aOR = 1.07; 95% CI, 1.04-1.11; P < 0.001), particularly among those prescribed atorvastatin and rosuvastatin. Subgroup analyses by duration of statin prescription (<1 year, 1-3 years, and >3 years) revealed a trend of higher glaucoma risk with longer statin use. Additionally, fibrate use was associated with an increased risk of ocular hypertension (aOR = 1.05; 95% CI, 1.00-1.10; P = 0.032), and POAG (aOR = 1.09; 95% CI, 1.03-1.15; P = 0.002).

Statin use, particularly atorvastatin and rosuvastatin, is associated with an increased risk of ocular hypertension and POAG among patients with hyperlipidemia. The risk appears to increase with longer durations of statin use.