Medications and cataract. The Blue Mountains Eye Study

Area of Science:

• Ophthalmology
• Pharmacology
• Epidemiology

Background:

• Corticosteroids are known to induce cataracts.
• The ocular effects of many other commonly used medications on cataract development remain largely unknown.
• Understanding medication-lens interactions is crucial for patient safety and clinical practice.

Purpose of the Study:

• To investigate the association between cataract formation and the use of various medications.
• Specific medications examined include allopurinol, aspirin, chloroquine, diuretics, phenothiazines, and simvastatin.

Main Methods:

• A population-based cross-sectional study involving 3654 participants aged 49-97 years.
• Lens photography was utilized to grade the presence and severity of cortical, nuclear, and posterior subcapsular cataracts.
• Ordinal regression models were employed for statistical analysis, adjusting for potential confounders.

Main Results:

• Phenothiazine use was linked to an increased risk of nuclear cataracts (OR, 2.18).
• Long-term aspirin use (≥10 years) showed a trend towards higher prevalence of posterior subcapsular cataracts (P=0.02).
• Mepacrine, an antimalarial, was significantly associated with posterior subcapsular cataracts (OR, 3.56); amiodarone was linked to cortical cataracts (OR, 3.84).

Conclusions:

• Most commonly used community medications do not appear to be associated with cataract development.
• The study does not support the hypothesis that aspirin confers protection against cataracts.
• Further research is needed for medications with suggestive associations, such as chloroquine and potassium-sparing diuretics.