Change in systemic medication and its influence on intraocular pressure – results from the Gutenberg Health Study

Abstract

Purpose : To investigate the relationship between change in systemic medication and intraocular pressure (IOP) on population-based level.

Methods : The Gutenberg Health Study is a population-based prospective observational cohort study in Germany. As part of the baseline examination (2007-2012) and 5-year follow-up examination (2012-2017), IOP was measured by non-contact tonometry. Current systemic medication was recorded at both time points. Univariable and multivariable regression analyses were carried out to analyze associations. Moreover, we calculated the dose-response relationship for the dosage change of selective beta-blockers with IOP change over 5 years.

Results : The analysis population included 19,161 eyes of 9,633 subjects. An mean increase in IOP of 0.73 mmHg in the right and 0.67 mmHg in the left eye was observed over five years. IOP was lower in subjects with new intake of selective beta-blockers (-0.32mmHg, p<0.001) and increased in those with discontinuation of selective beta-blocker intake (+0.28 mmHg; p=0.004). Associations between IOP change and diuretics, statins, and calcium channel blockers could be attributed to the influence of co-medications or in case of ACE inhibitors due to blood pressure change. There was a dose-response relationship for selective beta-blocker intake and change in IOP (-0.001 mmHg per mg, p=0.02).

Conclusions : Use of systemic selective beta-blockers is associated with IOP on a population level, while the association with other systemic medications on IOP could be explained by co-medication use or change in blood pressure. Asking patients about changes in systemic medications should form part of follow-up assessments of IOP regulation, i.e. in glaucoma patients.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.