Overall, patients on beta-blockers in this study had a lower IOP.
Overall, patients on beta-blockers in this study had a lower IOP. Photo: Pfizer. Click image to enlarge.

Upon investigating the association of systemic medication use with intraocular pressure (IOP) and glaucoma prevalence, researchers recently shared their findings at the 2022 ARVO meeting in Denver. Their study supported and quantified the known IOP-lowering effect of systemic beta-blockers but found no evidence of that same effect with other commonly used systemic medications. They added that calcium channel blocker use (both with vascular and direct cardiac effects) was associated with a higher prevalence of glaucoma but not with higher IOP.

The meta-analysis included 46,845 participants from 11 population-based studies of the European Eye Epidemiology consortium. IOP measurement method and glaucoma risk ascertainment were evaluated according to individual study protocols. Multivariable regression (linear for IOP and logistic for glaucoma) was conducted and results were pooled using random effects meta-analysis.

The team reported that beta-blocker use was associated with a lower IOP (all beta-blockers: -0.3mm Hg, non-selective beta-blockers: -0.56mm Hg, selective beta-blockers: -0.40mm Hg). Use of calcium channel-blockers was positively associated with a higher glaucoma prevalence (all calcium channel-blockers: 1.25, selective calcium channel-blockers with mainly vascular effects: 1.27, selective calcium channel-blockers with direct cardiac effects: 1.54).

“Further studies are required to probe whether this harmful association of calcium channel-blockers with glaucoma is causal,” the study authors wrote in their abstract.

Use of RAS inhibitors, diuretics, alpha-agonists, statins, fibrates, non-selective monoamine reuptake inhibitors, SSRIs and antidiabetic medications was not associated with IOP or glaucoma.

Original abstract content © Association for Research in Vision and Ophthalmology 2022.

Schuster A. Association of commonly used systemic medications with glaucoma prevalence and intraocular pressure across Europe: the E3 consortium. ARVO 2022 annual meeting.