[Health Focus] “Cholesterol drug statins reduce the risk of glaucoma and the possibility of additional treatment”

Dr. Robert Weinlev's team at the University of California, San Diego (UCSD) announced this in the British Journal of Ophthalmology on the 7th, saying that they analyzed the medical records of over 420,000 people over 40 years of age and confirmed that taking statins was associated with a lower risk of developing open-angle glaucoma and increasing the stage of glaucoma treatment.

The research team said that the results of this study suggest that taking statins is associated with not only a reduced risk of developing primary open-angle glaucoma, but also a reduced risk of advanced glaucoma treatment stages, and that taking statins needs to be considered in the long-term treatment and management of glaucoma.

Glaucoma is a disease that permanently damages the optic nerve and is a major cause of irreversible blindness worldwide, and the key to current treatment is lowering intraocular pressure.

However, the research team pointed out that there are patients whose disease continues to progress even when intraocular pressure is lowered, raising the possibility that factors other than intraocular pressure may be involved in optic nerve damage.

The research team analyzed the occurrence and treatment results of glaucoma in adults over 40 years of age using electronic medical records from the TriNetX medical research network, which includes 115 medical institutions.

In the analysis of glaucoma occurrence, 210,701 people in the statin taking group and the non-taking control group were compared, and in a separate treatment analysis, 29,598 people in each of the two groups were compared.

Statins are drugs that treat hypercholesterolemia, and the research team focused on the possibility of statins having a neuroprotective effect. In glaucoma, it has been suggested that neuroinflammation, immune cell activity, mechanical stress, and oxidative damage may be involved in optic nerve damage.

As a result of the analysis, over 5 years, 4,771 people (2.3%) in the statin taking group were newly diagnosed with open-angle glaucoma, and 5,491 people (2.6%) in the control group. The risk of developing glaucoma in the statin taking group was 15% lower than the control group, and the risk was 10% lower at 10 years.

In addition, in a comparison between the statin taking group and the non-taking control group among people with glaucoma, the risk of incision glaucoma surgery was 36% lower, the risk of minimally invasive glaucoma surgery (MIGS) was 55% lower, and the risk of selective laser trabeculoplasty (SLT) was 60% lower in the statin taking group at 5 years. The risk of prescribing topical intraocular pressure-lowering drugs to lower intraocular pressure was also 11% lower.

Even at 10 years, the risk of incisional glaucoma surgery in the statin-taking group was 32% lower, MIGS was 46% lower, SLT was 51% lower, and topical intraocular pressure lowering medication prescription was 12% lower than in the non-taking control group.

The research team explained that statins have the potential to improve retinal blood flow and reduce optic nerve damage by affecting immune responses and vascular function.

However, because this study was a retrospective observational study using past medical records, it did not directly confirm the mechanism of action of statins, and added that it cannot be concluded that statins prevent or treat glaucoma based on these results alone.

He went on to say that the significance of this study is that it presents large-scale data showing a correlation between taking statins and developing glaucoma and upgrading the treatment stage, adding that there is a need to confirm whether statins actually have an effect on glaucoma through prospective randomized clinical trials.

◆ Source: British Journal of Ophthalmology, Lin F, Hong AT, Weinreb RN., 'Statin use is associated with lower risk of open-angle glaucoma incidence and treatment escalation', doi:10.1136/bjo-2026-330339.