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Stephanie Chen, Kuldev Singh, Shan Lin; Association between self-reported phosphodiesterase inhibitor use and glaucoma in a representative sample of the US population. Invest. Ophthalmol. Vis. Sci. 2017;58(8):5609.
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© ARVO (1962-2015); The Authors (2016-present)
While optic neuropathy due to decreased ocular blood flow is a known cause of glaucoma, it is unclear what role systemic phosphodiesterase inhibitors (PDEi) play. We performed a retrospective, cross-sectional study of a nationally representative sample of the US population to investigate the relationship between the most commonly used PDEi, sildenafil and theophylline, and self-reported glaucoma.
We used the National Health and Nutrition Examination Survey 2005-2008 cycles for this observational study. 7,042 participants, age ≥40 years, responded to a survey item on glaucoma status and were included in the analysis. Multivariate logistic regression models were constructed to evaluate the association between ≥1 year of self-reported PDEi use and prevalent glaucoma. Regressions were adjusted for potential confounding variables, including demographics and general health conditions. Sample weights were used to ensure generalizability of results.
482 respondents self-reported a diagnosis of glaucoma (Table 1), of which 11 used sildenafil and 18 used theophylline for ≥1 year. Covariates significantly associated with higher odds of glaucoma in univariate analyses included older age, black race, former smoking status, diabetes, hyperlipidemia, myocardial infarction, and stroke (Table 2). In regression analyses adjusted only for age and gender, sildenafil (OR=5.14, CI: 1.17-22.60, p=0.031) and theophylline (OR=3.63, CI: 1.78-7.41, p=0.001) were significantly associated with self-reported glaucoma. These associations held after further adjustment with demographics and general health conditions for both sildenafil (OR=4.59, CI: 1.21-17.40, p=0.026) and theophylline (OR=2.91, CI: 1.44-5.85, p=0.004).
At least 1-year use of sildenafil or theophylline may be associated with self-reported glaucoma, perhaps by diverting blood flow away from the optic nerve.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
Table 1. Demographics and General Health Characteristics of Participants Based On Self-Reported Glaucoma Status
Table 2. Logistic Regression Models for Self-Reported Glaucoma and Risk Factors † Crude models adjusted only for age and female sex ‡ Adjusted models adjusted for demographics and general health comorbidities * Univariate regressions performed for each covariate Odds ratios (OR) are reported with 95% confidence intervals (CI) with two-sided p-values <0.05 deemed statistically significant
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