Risk of Glaucoma Progression in Patients Using a Calcium Channel Blocker: A Propensity-Matched Cohort Study

Purpose: To investigate the potential impact of calcium channel blocker (CCB) use on the progression of mild to moderate POAG to the severe stage. Methods: A retrospective cohort analysis was conducted using the TriNetX United States Collaborative Network to identify patients with mild or moderate POAG and more than 6 months of follow-up data. Patients were stratified by CCB use. The primary outcome was disease progression to severe POAG at any time point after the initial diagnosis, identified using International Classification of Diseases, Tenth Revision, code H40.1193. Patients with prior severe POAG or those prescribed angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, or beta-blockers were excluded. Propensity score matching (1:1) was conducted to control for age, sex, race, ethnicity, and hypertension. Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated. Results: After propensity score matching, 7446 patients were included: 3723 controls (no CCB use), 3039 taking dihydropyridine CCBs (dCCBs), and 684 taking nondihydropyridine CCBs (ndCCBs). The risk of severe POAG was significantly higher in patients using dCCBs (RR, 1.67; 95% CI, 1.23-2.27) and ndCCBs (RR, 3.62; 95% CI, 1.97-6.62) compared with controls. Conclusions: Both dCCBs and ndCCBs were associated with an increased risk of progression to severe POAG in patients with mild to moderate disease. Further research is needed to elucidate the underlying mechanisms of this association.