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. 2022 Nov 1;140(11):1055-1063.
doi: 10.1001/jamaophthalmol.2022.3723.

Association of Drugs With Acute Angle Closure

Kyeong Ik Na  1 , Sung Pyo Park  1
Affiliations

Association of Drugs With Acute Angle Closure

Kyeong Ik Na et al. JAMA Ophthalmol. .

Abstract

Importance: Acute angle-closure (AAC) glaucoma is a sight-threatening disease and can reportedly occur in association with various drugs.

Objective: To identify drugs that are associated with AAC glaucoma occurrence and evaluate the risk of AAC associated with each drug.

Design, setting, and participants: A case-crossover study was conducted using the Health Insurance Review and Assessment Service database, which contains medical information of the entire Korean population. Patients who were first diagnosed with AAC and treated between 2013 and 2019 were identified using diagnostic and procedure codes. All drugs that the study participants were prescribed as well as prescription dates during the period of 1 to 180 days before the onset of AAC were extracted from the database. For each patient, 1 to 30 days before onset was considered the hazard period, and 91 to 180 days before AAC onset was considered the control period.

Main outcomes and measures: Drugs associated with AAC and odds (calculated as odds ratios [ORs] with 95% CIs) of AAC development associated with each identified drug.

Results: A total of 949 drugs that were prescribed to 13 531 patients with AAC (mean [SD] age, 66.8 [10.6] years; 9585 [70.8%] female) during the period of 1 to 180 days before the onset of AAC were analyzed. A total of 61 drugs were found to be associated with AAC, among which sumatriptan (OR, 12.60 [95% CI, 4.13-38.44]) was associated with the highest odds of AAC development, followed by topiramate (OR, 5.10 [95% CI, 2.22-11.70]) and duloxetine (OR, 4.04 [95% CI, 2.95-5.54]). The median (IQR) period from prescription of the drug to the onset of AAC for the 61 drugs was 11.9 days (10.9-12.8). A number of drugs not previously considered to be associated with AAC, including lactulose (OR, 2.81 [95% CI, 1.72-4.61]) and metoclopramide (OR, 2.52 [95% CI, 1.95-3.25]), were identified.

Conclusions and relevance: Results of this case-crossover study suggest a need to consider AAC risk in patients taking any of the 61 drugs found to be associated with AAC.

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Conflict of interest statement

Conflict of Interest Disclosures: Dr Park reported receiving grants from the Korean Association of Retinal Degeneration and Basic Science Research Program through the National Research Foundation of Korea, funded by the Ministry of Science and Information and Communication Technology, outside the submitted work. No other disclosures were reported.

Comment in

References

    1. Flaxman SR, Bourne RRA, Resnikoff S, et al. ; Vision Loss Expert Group of the Global Burden of Disease Study . Global causes of blindness and distance vision impairment 1990-2020: a systematic review and meta-analysis. Lancet Glob Health. 2017;5(12):e1221-e1234. doi:10.1016/S2214-109X(17)30393-5 - DOI - PubMed
    1. GBD 2019 Blindness and Vision Impairment Collaborators; Vision Loss Expert Group of the Global Burden of Disease Study . Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the right to sight: an analysis for the Global Burden of Disease Study. Lancet Glob Health. 2021;9(2):e144-e160. doi:10.1016/S2214-109X(20)30489-7 - DOI - PMC - PubMed
    1. Tham YC, Li X, Wong TY, Quigley HA, Aung T, Cheng CY. Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis. Ophthalmology. 2014;121(11):2081-2090. doi:10.1016/j.ophtha.2014.05.013 - DOI - PubMed
    1. Vijaya L, George R, Arvind H, et al. . Prevalence of angle-closure disease in a rural southern Indian population. Arch Ophthalmol. 2006;124(3):403-409. doi:10.1001/archopht.124.3.403 - DOI - PubMed
    1. Aung T, Nolan WP, Machin D, et al. . Anterior chamber depth and the risk of primary angle closure in 2 East Asian populations. Arch Ophthalmol. 2005;123(4):527-532. doi:10.1001/archopht.123.4.527 - DOI - PubMed

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