Statin use not effective strategy for primary glaucoma prevention: Study

USA: A new study conducted by Jihye Kim and the team found no indication of a protective link between statin usage and glaucoma or associated features, after controlling for major confounders. The findings of this study were published in Investigative Ophthalmology & Visual Science.

Statins are a type of lipid-lowering medication that reduces 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase activity to lower low-density lipoprotein (LDL) cholesterol levels and are used to prevent cardiovascular disease. Studies on statin usage and glaucoma have shown conflicting findings. As a result, this study was designed to assess the connection between statin usage and glaucoma-related features.

This cross-sectional study includes data on statin usage and corneal-compensated IOP from 118,153 UK Biobank individuals. In addition, data on glaucoma status was collected from 192,283 individuals (8982 instances). After removing those with neurodegenerative illnesses, 41,638 people with macular retinal nerve fibre layer thickness (mRNFL) and 41,547 people with macular ganglion cell inner plexiform layer thickness (mGCIPL) were left for study.

Using multivariable-adjusted regression models, associations between statin usage and IOP, mRNFL, mGCIPL, and glaucoma status were investigated. To examine for changed relationships, the glaucoma polygenic risk score (PRS) was calculated. MR studies were carried out to examine relationships with various glaucoma-related outcomes.

The key findings of this study were as follows:

1. Statin users had greater unadjusted mean IOP SD than nonusers, but IOP did not differ by statin usage in a multivariable-adjusted model.

2. Similarly, statin usage was not linked to an increased risk of glaucoma.

3. Statin usage was related with thinner mRNFL but not with thicker mGCIPL.

4. The glaucoma PRS had no effect on the relationship.

5. MR tests revealed no indication of a link between statins' cholesterol-lowering impact and many glaucoma characteristics.

Overall, this data supports the notion that statin usage is not linked with favorable glaucoma outcomes and that statin use may not be an effective primary glaucoma preventive approach.

Reference:

Kim, J., Kennedy Neary, M. T., Aschard, H., Palakkamanil, M. M., Do, R., Wiggs, J. L., Khawaja, A. P., Pasquale, L. R., Kang, J. H., & International Glaucoma Genetics Consortium (IGGC), UK Biobank Eye and Vision Consortium, and Modifiable Risk Factors for Glaucoma Collaboration. (2022). Statin use in relation to intraocular pressure, glaucoma, and ocular coherence tomography parameters in the UK Biobank. Investigative Ophthalmology & Visual Science, 63(5), 31. https://doi.org/10.1167/iovs.63.5.31