I beta-bloccanti topici, fin dal loro primo utilizzo in campo oculistico, rappresentano una delle principali classi di farmaci oculari in grado di determinare una significativa riduzione della pressione intraoculare, quindi, del rischio glaucoma.
In ambito cardiologico così come in quello oculistico, nonostante il sempre più diffuso impiego di farmaci ad azione ipotonizzante di maggiore efficacia e sicurezza, l’uso dei beta-bloccanti rappresenta ancora una risorsa terapeutica importante e diffusa.
Sulla base del provato effetto oculare, scopo dello studio è di valutare se l’uso sistemico di farmaci beta-bloccanti e di statine possa avere un effetto positivo in termini di minore rischio di sviluppo di glaucoma.
Lo studio retrospettivo caso-controllo ha visto l’analisi del database di 177 strutture di medicina generale nel Regno Unito, arruolando per l’analisi 8778 pazienti affetti da glaucoma/terapia e 8778 pazienti controllo senza glaucoma dal 2000 al 2007.
Lo studio ha evidenziato l’importanza dei beta-bloccanti a1 selettivi nel prevenire lo sviluppo del glaucoma nei soggetti non affetti e come le statine non sembrano avere un ruolo protettivo.



Investigative Ophthalmology & Visual Science
Hypotensive Medication, Statins, and the Risk of Glaucoma

Christopher G. Owen; Iain M. Carey; Sunil Shah; Stephen de Wilde; Richard Wormald; Peter H. Whincup; Derek G. Cook

Investigative Ophthalmology & Visual Science
July 2010



Purpose.: To examine whether treatment with oral blood-pressure–lowering medication or statins influences the risk of glaucoma.

Methods.: This study was a case–control investigation, nested within a computerized primary care database of 177 general practices across the United Kingdom; 8778 cases diagnosed and/or treated for glaucoma between 2000 and 2007, and 8778 glaucoma-free controls matched for age, sex, and practice. Odds ratios for treatment with oral antihypertensives (including selective β1 and nonselective β-blockers) and statins in the 5 years before diagnosis were calculated by logistic regression, adjusted for a marker of socioeconomic position and number of drug types prescribed (as a measure of health service usage).

Results.: Prevalence of oral β-blocker use in the 5 years before diagnosis was lower in the cases (22.5%) than in the controls (23.6%), adjusted odds ratio (OR) 0.87 (95% confidence interval [CI], 0.80–0.94). This effect was presence with treatment with β1-selective medications (OR, 0.81; 95% CI, 0.74–0.88) but not with nonselective medications (OR, 1.08; 95% CI, 0.94–1.24). The prevalence of thiazide use was higher among the glaucoma cases than among the controls (OR, 1.13; 95% CI, 1.04–1.23). Neither statins nor other antihypertensive treatments were associated with the risk of glaucoma.

Conclusions.: Oral β1 β-blockers may protect against development of glaucoma. The current consensus on the relative importance of β2 receptor blockade in treating glaucoma may have to be reviewed. Changes in prescribing oral β-blockers for cardiovascular disorders may affect the number of those who eventually have glaucoma. There is no evidence to suggest that statins have a preventive role in glaucoma..: To examine whether treatment with oral blood-pressure–lowering medication or statins influences the risk of glaucoma.