McGwin Gerald, McNeal Sandre, Owsley Cynthia, Girkin Christopher, Epstein David, Lee Paul P
Department of Ophthalmology, School of Medicine, University of Alabama at Birmingham, Birmingham, USA.
Arch Ophthalmol. 2004 Jun;122(6):822-6. doi: 10.1001/archopht.122.6.822.
To explore whether oral statin and other antihyperlipidemic medications are associated with open-angle glaucoma.
The administrative clinical databases maintained at the Veterans Affairs Medical Center, Birmingham, Ala, were used to conduct a matched case-control study. Cases were all male patients aged 50 years and older with a new diagnosis of glaucoma on an outpatient or inpatient visit during the period January 1, 1997, through December 31, 2001. Ten control subjects were matched to each case according to age (within 1 year). Prescription files were assessed for statin use as well as additional medications to lower cholesterol levels. Information on comorbid medical conditions was also obtained. Conditional logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs).
Longer duration of statin use was associated with a lower risk of open-angle glaucoma (P for trend =.04) primarily among subjects with 24 months or more of use (OR, 0.60; 95% CI, 0.39-0.92). When stratified by comorbid medical condition, among those with cardiovascular disease (OR, 0.63; 95% CI, 0.42-0.97), lipid metabolism disorders (OR, 0.63; 95% CI, 0.41-0.99), and the absence of cerebrovascular disease (OR, 0.76; 95% CI, 0.58-0.99), statins demonstrated a protective effect on open-angle glaucoma. Finally, a protective association was also observed among those who used nonstatin cholesterol-lowering agents (OR, 0.59; 95% CI, 0.37-0.97).
Initial examination of an administrative clinical database indicates the intriguing possibility that long-term use of oral statins may be associated with a reduced risk of open-angle glaucoma, particularly among those with cardiovascular and lipid diseases. Nonstatin cholesterol-lowering agents were also associated with a reduced risk of having open-angle glaucoma. Additional investigation is warranted as to whether these classes of agents may provide an additional therapeutic addition for glaucoma.
探讨口服他汀类药物及其他降血脂药物与开角型青光眼是否有关联。
利用阿拉巴马州伯明翰退伍军人事务医疗中心维护的管理临床数据库进行一项匹配病例对照研究。病例为1997年1月1日至2001年12月31日期间门诊或住院时新诊断为青光眼的所有50岁及以上男性患者。根据年龄(1年内)为每个病例匹配10名对照受试者。评估处方档案中他汀类药物的使用情况以及其他降低胆固醇水平的药物。还获取了合并症的信息。采用条件逻辑回归计算比值比(OR)和95%置信区间(CI)。
他汀类药物使用时间较长与开角型青光眼风险较低相关(趋势P值 = 0.04),主要发生在使用24个月或更长时间的受试者中(OR,0.60;95% CI,0.39 - 0.92)。按合并症分层时,在患有心血管疾病(OR,0.63;95% CI,0.42 - 0.97)、脂质代谢紊乱(OR,0.63;95% CI,0.41 - 0.99)以及无脑血管疾病(OR,0.76;95% CI,0.58 - 0.99)的患者中,他汀类药物对开角型青光眼显示出保护作用。最后,在使用非他汀类降胆固醇药物的患者中也观察到了保护关联(OR,0.59;95% CI,0.37 - 0.97)。
对管理临床数据库的初步检查表明,长期使用口服他汀类药物可能与开角型青光眼风险降低有关,这一可能性引人关注,尤其是在患有心血管疾病和脂质疾病的患者中。非他汀类降胆固醇药物也与开角型青光眼风险降低有关。对于这些药物类别是否可为青光眼提供额外的治疗补充,有必要进行进一步研究。