A U.S. study reveals that individuals with glaucoma undergoing treatment with statins appear to have a lower likelihood of needing treatment intensification, such as additional eye drops or surgical intervention, to manage the disease.
Glaucoma, one of the leading causes of irreversible blindness, results from permanent damage to the optic nerve. The findings of this new study are published in the British Journal of Ophthalmology.
The hypothesis of a positive "side effect" of statins
Statins are prescribed to lower cholesterol levels, but some studies suggest they may also help prevent or delay the death of nerve cells. However, their potential role in preventing or slowing the progression of glaucoma is not yet fully understood.
To expand the available evidence, researchers analyzed a large global database containing information from 165 million people.
They compared over 210,000 individuals with a history of statin use between August 2006 and August 2026 with an equivalent control group of over 210,000 people without a record of treatment with these drugs. All participants had to undergo ophthalmological follow-up.
The analysis showed that statin use was associated with a 15% lower risk of developing open-angle glaucoma.
After five years, 4,771 new glaucoma diagnoses were recorded among individuals treated with statins, 2.3%, compared to 5,491 cases in the control group, 2.6%.
In an independent analysis, researchers compared over 30,000 individuals with glaucoma taking statins with nearly 250,000 glaucoma patients not using them.
Fewer surgeries for those taking statins
Among those already suffering from the disease, statin treatment was associated with a lower likelihood of needing therapeutic intensification, including surgery or other procedures to control glaucoma.
After five years, its use was linked to a 36% lower risk of incisional glaucoma surgery and a 55% lower risk of minimally invasive glaucoma surgery aimed at reducing intraocular pressure.
Statins were also associated with a 60% lower risk of undergoing selective laser trabeculoplasty, a procedure that reduces intraocular pressure using laser, and a 12% decrease in the need for eye drops to control it.
After 10 years of follow-up, the association with a lower risk of these three procedures and eye drop use persisted. As an observational study, the results do not establish a cause-and-effect relationship.
Research limitations
One of its limitations is that researchers did not have access to individual patient data, such as intraocular pressure measurements or details of surgical interventions. Therefore, they could not determine if surgeries were performed due to the disease's severity or other factors, such as low treatment adherence.
Despite these limitations, the authors believe the results add to the growing evidence on the potential neuroprotective effect of statins. However, they note that prospective randomized trials will be necessary to better clarify their potential influence on both glaucoma incidence and treatment.
"Our findings suggest that statin use is associated with both a lower incidence of primary open-angle glaucoma and a reduced need to intensify treatment," conclude the researchers.