Statin use is associated with lower risk of open-angle glaucoma incidence and treatment escalation

Background Retrospective cohort study using the TriNetX database to explore the relationship between statin use and glaucoma. Methods The open-angle glaucoma (OAG) incidence analysis consisted of individuals over 40 years of age with statin use and ophthalmological follow-up within 1 year prior. The OAG treatment analysis consisted of individuals with glaucoma and concurrent statin use. Outcomes included rates of OAG onset, topical ocular hypotensive prescription, incisional glaucoma surgery, minimally invasive glaucoma surgery (MIGS) and selective laser trabeculoplasty (SLT). Results 210 701 matched patients were included in the OAG incidence analysis and 29 598 in the OAG treatment analysis. At 5 years, statin use was associated with lower risk of OAG incidence (HR 0.85 (95% CI 0.82 to 0.89)), as well as treatment escalation to incisional glaucoma surgery (HR 0.64 (95% CI 0.58 to 0.71)), MIGS (HR 0.45 (95% CI 0.41 to 0.50)) or SLT (HR 0.40 (95% CI 0.36 to 0.44)) and lower rates of topical ocular hypotensive prescription (HR 0.89 (95% CI 0.86 to 0.91)). At 10 years, statin use was associated with lower risk of OAG incidence (HR 0.90 (95% CI 0.87 to 0.93)), escalation to incisional glaucoma surgery (HR 0.68 (95% CI 0.63 to 0.75)), MIGS (HR 0.54 (95% CI 0.49 to 0.59)) or SLT (HR 0.49 (95% CI 0.45 to 0.52)) and lower rates of topical ocular hypotensive prescription (HR 0.88 (95% CI 0.86 to 0.91)). Conclusions Our results suggest that statin use is associated with lower risk of glaucoma onset and treatment escalation. Prospective trials are needed to further elucidate the relationship between statin usage and glaucoma.