Key result
Statin use is linked to ~15% lower risk of open-angle glaucoma at 5 years.
Why the study?
The relationship between statin use and open-angle glaucoma incidence and treatment escalation was unclear and required investigation.
Does statin use reduce open-angle glaucoma incidence and treatment escalation in individuals over 40 years of age?
Cohort (n=421,402)
Yes
Does statin use reduce open-angle glaucoma incidence and treatment escalation in individuals over 40 years of age?
Statin use is associated with a significantly lower risk of developing open-angle glaucoma and a decreased need for subsequent glaucoma treatment escalation or surgery.
Answers are grounded in this paper and cite their sources.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Statins are known to have pleiotropic effects beyond cholesterol lowering, including anti-inflammatory and potential neuroprotective properties. This study suggests those effects could be relevant to optic nerve health, and future studies will be able to tell us if this is a causal, clinically actionable relationship.”
“Our findings suggest that statin usage is associated with both lower incidence of primary open-angle glaucoma as well as decreased treatment escalation. Prospective randomised trials are now needed to better understand the effects of statin use on glaucoma incidence and treatment, they add.”
“Glaucoma, a leading cause of irreversible blindness, is caused by permanent damage to the optic nerve. Statins are prescribed to lower cholesterol levels but studies have indicated that they may also prevent or slow nerve cell death. Their potential role in preventing or slowing down glaucoma is poorly understood.”
Statin use was associated with lower OAG incidence; leaves open a neuroprotective role pending randomized confirmation before any practice change.
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.
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Lin et al. (2026) conducted a cohort in Open-angle glaucoma risk (n=421,402). Statin use vs. No statin use was evaluated on New ICD-10 diagnosis of open-angle glaucoma at 5 years (HR 0.85, 95% CI 0.82 to 0.89, p=<0.001). Statin use was associated with a 15% reduced risk of open-angle glaucoma incidence at 5 years compared to no statin use.
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