Objective:
To investigate the association between calcium channel blockers (CCBs) and the risk of progression to severe primary open-angle glaucoma (POAG).
Approach:
- Study Design: A large retrospective cohort study analyzing electronic health record data from over 7,400 patients with mild to moderate POAG using the TriNetX US Collaborative Network.
- Patient Stratification: Patients diagnosed with mild or moderate POAG between 2004 and 2024 were stratified based on CCB use, excluding those on beta-blockers, ACE inhibitors, or angiotensin receptor blockers.
- Propensity Score Matching: After matching for age, sex, race, ethnicity, and hypertension status, the study included 3,039 patients taking dihydropyridine CCBs (dCCBs), 684 taking nondihydropyridine CCBs (ndCCBs), and matched controls.
Key Findings:
- 3.5% of dCCB users progressed to severe POAG compared to 2.1% of matched controls.
- 6.9% of ndCCB users progressed to severe POAG compared to 1.9% of controls.
- dCCB use was associated with a 67% higher relative risk of progression to severe POAG compared to controls.
- ndCCBs carried more than a threefold increased risk of progression to severe POAG compared to controls.
Interpretation:
Limitations:
- Reliance on ICD-10 coding.
- Lack of detailed intraocular pressure and visual field data.
- Inability to assess medication adherence or duration of therapy.
- Possible residual confounding from systemic disease severity.
Conclusion:
Sources:
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