Statins and Glaucoma: Lower OAG Incidence and Treatment Escalation

Statin use was associated with lower risks of developing open-angle glaucoma (OAG) and of glaucoma treatment escalation in a large retrospective cohort study published in the British Journal of Ophthalmology. Investigators analyzed deidentified electronic medical records from the TriNetX research network.

According to the authors, intraocular pressure (IOP) is the only modifiable risk factor proven to be associated with glaucoma, yet many patients continue to worsen despite IOP lowering. They noted that statins have drawn interest for potential neuroprotective effects, but prior studies have yielded inconsistent results.

The incidence analysis compared adults over 40 years of age who had ophthalmology follow-up within 1 year before their first recorded statin use with controls who had no statin record. After propensity score matching, each cohort included 210,701 individuals. At 5 years, statin use was associated with a lower risk of OAG onset (hazard ratio [HR], 0.85; 95% CI, 0.82-0.89), with new diagnoses in 2.3% of statin users and 2.6% of controls. At 10 years, the HR was 0.90 (95% CI, 0.87-0.93).

The treatment analysis included 29,598 matched individuals per cohort with an existing OAG diagnosis. At 5 years, statin use was associated with lower risks of incisional glaucoma surgery (HR, 0.64), minimally invasive glaucoma surgery (HR, 0.45), selective laser trabeculoplasty (HR, 0.40), and topical ocular hypotensive prescription (HR, 0.89); these associations persisted at 10 years.

The authors noted several limitations. TriNetX does not report IOP, visual field, or optic nerve imaging data, limiting patient-level assessment of disease progression and severity, and procedures may have been performed for other reasons, such as medication nonadherence or intolerance. Residual confounding may have affected results, and causality cannot be inferred from the observational design. The investigators called for prospective randomized trials to clarify the relationship between statin use and glaucoma.

Source: Lin F, Hong AT, Weinreb RN. Statin use is associated with lower risk of open-angle glaucoma incidence and treatment escalation. Br J Ophthalmol. Published online October 6, 2026. doi:10.1136/bjo-2026-330339