A large observational study published in the British Journal of Ophthalmology found that statin use was associated with a 15% lower risk of developing open-angle glaucoma and a 60% reduced likelihood of needing selective laser trabeculoplasty, a common glaucoma treatment.
Research published in the British Journal of Ophthalmology reveals a significant association between statin use and reduced glaucoma risk, with statin users showing lower rates of disease progression and treatment escalation. The findings, based on a global database of 165 million individuals, highlight potential neuroprotective effects of statins beyond their well-established role in cardiovascular health.
Study Design and Key Findings
The study analyzed data from 210,701 matched patients over 40 with ophthalmological follow-up, comparing statin users to non-users. At five years, statin use was linked to a 15% lower risk of developing open-angle glaucoma (2.3% vs. 2.6% incidence) and a 10% reduction at 10 years. For patients already diagnosed with glaucoma, statins were associated with a 36% lower risk of incisional surgery, 55% lower risk of minimally invasive glaucoma surgery (MIGS), and 60% lower risk of selective laser trabeculoplasty (SLT) [1]. At 10 years, statin use continued to show reduced risks: 10% lower risk of open-angle glaucoma (HR 0.90), 27% lower risk of incisional surgery (HR 0.73), 46% lower risk of MIGS (HR 0.54), and 51% lower risk of SLT (HR 0.49) [2].
The study also noted a 12% reduced risk of eye drop prescriptions among statin users, though the mechanisms remain unclear [3]. A separate analysis of 29,598 matched patients with existing glaucoma found statin users had a 36% lower risk of incisional surgery (HR 0.64), 55% lower risk of MIGS (HR 0.45), and 60% lower risk of SLT (HR 0.40) at five years [4].
The study leveraged a global database of 165 million de-identified health records, with statin users matched to non-users based on age, sex, race, and comorbidities. Over five years, 4,771 new glaucoma diagnoses occurred in the statin group (2.3%) versus 5,491 in the control group (2.6%) [5]. For patients with existing glaucoma, statin users faced a 36% lower risk of incisional surgery (HR 0.64), 55% lower risk of MIGS (HR 0.45), and 60% lower risk of SLT (HR 0.40) [6]. At 10 years, these associations persisted but were smaller, with 32% lower risk of incisional surgery (HR 0.68), 46% lower risk of MIGS (HR 0.54), and 51% lower risk of SLT (HR 0.49) [7].
Variation by Statin Type and Study Limitations
For example, atorvastatin users had a 17% lower risk of open-angle glaucoma (HR 0.83) and a 33% lower risk of incisional surgery (HR 0.67) compared to non-users [8]. The study’s authors acknowledged limitations, including the absence of intraocular pressure measurements and inability to determine why procedures were performed—whether due to disease progression or treatment non-adherence [9].
The researchers noted that propensity matching accounted for variables in health records, but unmeasured factors like adherence and statin dose could have influenced results. They also could not assess eye drop use during the study period, which might affect glaucoma outcomes [10]. The database lacked visual field tests and optic nerve imaging, so progression was measured indirectly through treatment escalation [11].
Implications for Glaucoma Management
The study adds to growing evidence of statins’ neuroprotective potential, though experts caution against drawing causal conclusions. Glaucoma, a leading cause of irreversible blindness, currently relies on intraocular pressure reduction as the only modifiable risk factor. The findings could influence future treatment strategies, particularly for patients at high risk of disease progression [12].
While the research does not recommend starting statins for glaucoma prevention, it underscores the importance of further investigation into their broader therapeutic applications. As Weinreb noted, Prospective randomized trials are needed to better understand the effects of statin use on glaucoma incidence and treatment
[3]. The study’s authors also highlighted possible mechanisms, including effects on immune cell activity, improved retinal blood flow, and reduced oxidative damage [13].
The research team, led by Lin, F. et al., published their findings in the British Journal of Ophthalmology with the DOI: 10.1136/bjo-2026-330339 [14]. They emphasized that while statins showed promise, their role in glaucoma management requires confirmation through randomized trials.