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2015 HSR&D/QUERI National Conference Abstract

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3045 — The influence of oral statin medications on the progression of glaucoma

Muir KW, Durham HSR&D; Whigham B, Durham HSR&D; Woolson S, Durham HSR&D; Coffman C, Durham HSR&D; Oddone EZ, Durham HSR&D;

Objectives:
To examine whether oral statin use is associated with less progression of glaucomatous visual field loss in a sample of Veterans with confirmed glaucoma.

Methods:
In a retrospective cohort study, medical records of Veterans with a diagnosis of open angle glaucoma, ?2 visual fields performed at least 6 months apart between 1/1/2005 - 1/1/2011 at the Durham VAMC, and no history of glaucoma surgery were identified. Eligible records were manually screened to confirm eligibility, collect statin use history, record demographic and comorbid medical conditions, and review visual fields. Visual fields were deemed reliable if the testing algorithm indicated that the test-taker had < 33% false positives, false negatives, and fixation loss. Visual fields were reviewed by one glaucoma specialist masked to statin history and judged (for each eye) as glaucomatous progression, no glaucomatous progression, or indeterminate. Progression rates in a propensity score matched cohort were compared between statin users and nonusers using McNemar's test with the propensity model derived using associated medical and demographic factors.

Results:
The initial screen of electronic records identified 1319 possible subjects and of these, 847 met predefined eligibility requirements. Thirty-one percent of Veterans demonstrated glaucomatous progression in at least one eye, 49% did not demonstrate progression, and 20% were indeterminate. Approximately 74% of subjects had previously used a statin, with this group having heavier burdens of several comorbid medical conditions and less severe baseline glaucoma than nonusers. The matched cohort was 196 statin users and 196 nonusers each with similar baseline characteristics (standardized differences < 0.10). Progression rates were 35% for statins users compared to 56% for nonusers in the matched cohort (McNemar's p = 0.0003).

Implications:
In this population of Veterans, glaucoma patients with any history of statin use have lower visual field progression rates than statin nonusers.

Impacts:
The association between statins and reduced glaucoma progression in US Veterans adds to growing evidence that statins may protect against glaucoma.