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.
Frank Brodie, MD, MBA, presents the surgical technique for subretinal placement of the PRIMA implant, an investigational therapy for advanced geographic atrophy.
