June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Association of commonly used systemic medications with glaucoma prevalence and intraocular pressure across Europe: the E3 Consortium
Author Affiliations & Notes
  • Alexander Karl-Georg Schuster
    Department of Ophthalmology, University Medical Center Mainz, Germany
  • Joëlle Vergroesen
    Department of Ophthalmology, Erasmus Universiteit Rotterdam, Rotterdam, Netherlands
  • Kelsey Vernon Stuart
    NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, United Kingdom
  • Geir Bertelsen
    UiT Norges arktiske universitet Institutt for samfunnsmedisin, Tromso, Troms, Norway
  • Fotis Topouzis
    Department of Ophthalmology, Aristotle University of Thessaloniki, School of Medicine, AHEPA Hospital, Greece
  • Mukharram Bikbov
    Ufimskij naucno-issledovatel'skij institut glaznyh boleznej, Ufa, Bashkortostan, Russian Federation
  • Catherine Creuzot-Garcher
    Service d'Ophtalmologie du CHU Dijon, France
  • Cecile Delcourt
    Universite de Bordeaux, Bordeaux Population Health Research Center, France
  • Rufino Silva
    Ophthalmology Department. Centro Hospitalar e Universitário de Coimbra (CHUC), Portugal
    Association for Innovation and Biomedical Research on Light and Image (AIBILI), Coimbra, Portugal
  • Nomdo M Jansonius
    Groningen University, Department of Ophthalmology, Netherlands
  • Franziska G Rauscher
    Institute for Medical Informatics, Statistics and Epidemiology, Leipzig University, Germany
    Leipzig Research Centre for Civilization Diseases (LIFE), Leipzig University, Germany
  • Caroline C W Klaver
    Department of Ophthalmology, Erasmus MC, Rotterdam, Netherlands
    Department of Epidemiology, Erasmus MC, Rotterdam, Netherlands
  • Norbert Pfeiffer
    Department of Ophthalmology, University Medical Center Mainz, Germany
  • Wishal D Ramdas
    Department of Ophthalmology, Erasmus Universiteit Rotterdam, Rotterdam, Netherlands
  • Anthony P Khawaja
    NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust & UCL Institute of Ophthalmology, London, United Kingdom
  • Footnotes
    Commercial Relationships   Alexander Schuster Allergan, Bayer, Novartis, Heidelberg Engineering, Code F (Financial Support); Joëlle Vergroesen None; Kelsey Stuart None; Geir Bertelsen None; Fotis Topouzis None; Mukharram Bikbov None; Catherine Creuzot-Garcher None; Cecile Delcourt None; Rufino Silva Alimera; Allergan; Bayer; Novartis; Roche; Thea; Novus Nordisk, Code C (Consultant/Contractor); Nomdo Jansonius None; Franziska Rauscher None; Caroline Klaver None; Norbert Pfeiffer None; Wishal Ramdas None; Anthony Khawaja None
  • Footnotes
    Support  None.
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 2267. doi:
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      Alexander Karl-Georg Schuster, Joëlle Vergroesen, Kelsey Vernon Stuart, Geir Bertelsen, Fotis Topouzis, Mukharram Bikbov, Catherine Creuzot-Garcher, Cecile Delcourt, Rufino Silva, Nomdo M Jansonius, Franziska G Rauscher, Caroline C W Klaver, Norbert Pfeiffer, Wishal D Ramdas, Anthony P Khawaja; Association of commonly used systemic medications with glaucoma prevalence and intraocular pressure across Europe: the E3 Consortium. Invest. Ophthalmol. Vis. Sci. 2022;63(7):2267.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To investigate the association of common systemic medication use with intraocular pressure and glaucoma prevalence in the European population.

Methods : We examined associations of systemic medication use with intraocular pressure and glaucoma prevalence in a meta-analysis of multiple cohort studies of the European Eye Epidemiology (E3) consortium. IOP measurement method and glaucoma ascertainment were according to individual study protocols. Multivariable regression (linear for IOP and logistic for glaucoma prevalence) was carried out in each study and results pooled using random effects meta-analysis. Age, sex, body-mass index and diabetes were included as co-variables. Associations of antidiabetic medications were evaluated only in diabetic subjects.

Results : A total of 46,845 participants from 11 population-based studies from the E3-consortium were included. In the meta-analysis of our fully-adjusted multivariable models, beta-blocker usage was associated with a lower IOP (all beta-blockers: Beta=-0.33 mmHg, 95% confidence interval (CI)=-0.58 to -0.08; non-selective betablockers: Beta=-0.56, 95% CI=-0.92 to -0.21; selective betablockers: Beta= -0.40, 95% CI=-0.64 to -0.16). In the meta-analysis of our fully-adjusted multivariable models, usage of calcium-channel blockers was positively associated with a higher glaucoma prevalence (all calcium-channel blockers: OR=1.25, 95% CI=1.05 to 1.50; selective calcium-channel blockers with mainly vascular effects: OR=1.27, 95% CI=1.05 to 1.53; selective calcium-channel blockers with direct cardiac effects: OR=1.54, 95% CI=1.07 to 2.21). Usage of RAS-inhibitors, diuretics, alpha-agonists, statins, fibrates, non-selective monoamine reuptake inhibitors, selective serotonin reuptake inhibitors, and antidiabetic medications was not associated with IOP or glaucoma.

Conclusions : Our study supports and quantifies the known IOP-lowering effect of systemic beta-blockers, but there was no evidence of an IOP-lowering effect of other commonly used systemic medications. The usage of calcium-channel blockers (both with vascular and direct cardiac effects) was associated with a higher prevalence of glaucoma but not with higher IOP. Further studies are required to probe whether this harmful association of calcium-channel blockers with glaucoma is causal.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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