Association of Systemic Medication Use with Glaucoma and Intraocular Pressure : The European Eye Epidemiology Consortium

 

Created
Tags Glaucoma
Journal Ophthalmology
Status 審查完成
校稿者 蕭靜熹 醫師

Ophthalmology Volume 130, Number 9, September 2023

全身性藥物使用與青光眼和眼壓的關聯性:歐洲眼科流行病學聯盟研究

中文摘要

這是一篇研究文章的詳細摘要,探討常用全身性藥物與青光眼之間的關聯性,特別關注了鈣通道阻滯劑(calcium channel blockers, CCBs)和systemic β-blockers。這項研究似乎發現了CCBs使用與青光眼盛行率之間的潛在有害關聯,以及systemic β-blockers使用與較低眼內壓(IOP)之間的有益關聯。

以下是整理出的一些關鍵點:

CCBs:研究發現CCBs使用與青光眼盛行率增加之間存在顯著關聯。Odd ratio(OR)為1.96,95%信賴區間(CI)為1.23至3.12。這表明使用CCBs的人與不使用這些藥物的人相比,可能患青光眼的機會幾乎是兩倍。

Systemic β-blockers:研究發現β-blockers與較低的IOP之間存在關聯,這在青光眼的背景下通常被認為是有益的。

其他藥物:研究還考慮了其他藥物,如 angiotensin-converting enzyme inhibitors(ACEIs)、 angiotensin-converting enzyme inhibitors(ARBs)、statins和sulfonylureas ,但在研究中發現結果不一致。

混雜因素 (Cofounding factors):研究考慮了重要的混雜因素,如收縮壓和糖尿病,但承認殘餘混雜可能無法排除。

臨床相關性:如果進一步的研究確認這些發現,這對於高血壓患者的管理,尤其是那些患有或有患青光眼風險的患者,可能會有重大影響。

進一步研究:作者呼籲進行長期研究以確認這些發現並確定因果關係。

限制:該研究存在一些限制,包括對藥物持續時間或劑量的數據缺乏,並且大多數數據是在10年前收集的。

值得注意的是,雖然這些發現很有趣,但它們並不是這些藥物與青光眼之間因果關係的定論性證據。需要進一步的研究來確認這些關聯性並探索可能的機制。

English Abstract

Its a detailed summary of a research article that investigates the association between commonly used systemic medications and glaucoma, including 4 categories of systemic medications: antihypertensive medications(b-blockers,diuretics, calcium channel blockers [CCBs],a-agonists, angiotensin-converting enzyme inhibitors,and angiotensin II receptor blockers), lipid-lowering medications,antidepressants,and anti-diabetic medications with glaucoma prevalence and IOP. The study seems to have found a potentially harmful association between the use of calcium channel blockers (CCBs) and the prevalence of glaucoma, as well as a beneficial association between systemic beta-blockers and lower IOP.

Here are some key points I gathered from the text:

  1. Calcium Channel Blockers (CCBs): The study found a significant association between the use of CCBs and increased glaucoma prevalence. The odds ratio (OR) was 1.96, with a 95% confidence interval (CI) of 1.23 to 3.12. This suggests that people who use CCBs may have almost twice the odds of having glaucoma compared to those who don’t use these medications.
  1. Systemic Beta-Blockers: The study found that systemic beta-blockers were associated with lower IOP, which is generally considered beneficial in the context of glaucoma.
  1. Other Medications: The study also looked at other medications like angiotensin-converting enzyme inhibitors (ACEIs), angiotensin-converting enzyme inhibitors (ARBs), statins, and sulfonylureas but found inconsistent results across studies.
  1. Confounding Factors: The study accounted for important confounders like systolic blood pressure and diabetes mellitus but acknowledges that residual confounding cannot be excluded.
  1. Clinical Relevance: If further studies confirm these findings, this could have significant implications for the management of patients with hypertension who also have or are at risk of glaucoma.
  1. Further Studies: The authors call for longitudinal studies to confirm these findings and determine causality.
  1. Limitations: The study had some limitations, including the lack of data on medication duration or dosage, and the fact that most of the data was collected more than 10 years ago.

It’s important to note that while these findings are intriguing, they are not definitive proof of a causal relationship between these medications and glaucoma. Further studies are needed to confirm these associations and to explore potential mechanisms.