Summary:
A large real-world epidemiological study from the UC San Diego School of Medicine finds that statin medications are linked to a substantially lower risk of developing open-angle glaucoma and a markedly reduced likelihood of needing laser or surgical escalation among patients who already have the disease.
Using health records from more than 420,000 propensity-matched individuals across a 20-year period and reported in the British Journal of Ophthalmology, the research team found statin users experienced about a 15% lower incidence of open-angle glaucoma and up to a 55–60% lower rate of surgical or laser interventions compared with matched non-users.
Key Facts:
- Lower glaucoma incidence: Statin use was associated with an approximately 15% relative risk reduction in developing open-angle glaucoma over five years versus matched non-users.
- Reduced escalation to surgery or laser: Among patients with established glaucoma, use of statins correlated with a 36% lower risk of traditional incisional surgery, a 55% reduction in minimally invasive glaucoma surgery (MIGS), and a 60% lower risk of selective laser trabeculoplasty (SLT).
- Large international dataset: The investigators analyzed electronic health records from a federated registry covering roughly 165 million patients, forming over 210,000 matched pairs with follow-up between August 2006 and August 2026.
Source: UC San Diego School of Medicine / British Journal of Ophthalmology
Overview: Glaucoma is a leading global cause of irreversible vision loss caused by progressive degeneration of retinal ganglion cells and optic nerve fibers. Current treatment primarily targets lowering intraocular pressure (IOP) with topical medications, lasers, or surgery, but lowering IOP does not always stop neurodegeneration. Statins—HMG-CoA reductase inhibitors widely used to reduce LDL cholesterol and cardiovascular risk—also have anti-inflammatory, antioxidant, endothelial-supporting, and neuroprotective effects that could plausibly benefit the optic nerve.
Until now, whether those systemic, pleiotropic effects of statins translate into measurable protection against glaucoma onset or progression in humans has remained uncertain. The new observational study led by UC San Diego researchers provides robust population-scale evidence suggesting statin exposure is associated with both reduced incidence of open-angle glaucoma and less frequent escalation to advanced therapies among people with glaucoma.
Published online in the British Journal of Ophthalmology, the analysis indicates that people prescribed statins were less likely to be diagnosed with open-angle glaucoma and, when glaucoma was present, were less likely to need laser procedures or surgery during follow-up.
“Glaucoma causes irreversible vision loss worldwide, and statins are among the most commonly prescribed drugs for cardiovascular disease prevention,” said senior author Robert Weinreb, M.D., Distinguished Professor at UC San Diego School of Medicine and Director of the Hamilton Glaucoma Center. “If these associations are confirmed in randomized studies, the implications could affect many patients.”
Study design and data sources
To address inconsistent findings from earlier smaller studies, the research team from UC San Diego, the University of South Florida, and the University of Southern California accessed a federated global database encompassing approximately 165 million individuals. They constructed two main cohorts for targeted analyses:
- Incidence cohort: 210,000 adults with documented statin use between August 2006 and August 2026 were propensity matched to 210,000 adults without statin exposure. All subjects had longitudinal ophthalmic follow-up. Over five years, 2.3% of statin users developed open-angle glaucoma versus 2.6% of non-users, a statistically significant 15% relative reduction.
- Progression cohort: A secondary analysis compared more than 30,000 glaucoma patients taking statins with nearly 250,000 glaucoma patients not taking statins to evaluate treatment escalation.
Findings on treatment escalation
Among patients already diagnosed with glaucoma, statin exposure was associated with significantly lower rates of treatment escalation at both five- and ten-year follow-ups. At five years, statin use correlated with:
- A 60% lower risk of undergoing selective laser trabeculoplasty (SLT).
- A 55% lower risk of requiring minimally invasive glaucoma surgery (MIGS).
- A 36% lower risk of traditional incisional glaucoma surgery, such as trabeculectomy or tube-shunt implantation.
- A 12% lower risk of needing additional topical intraocular pressure–lowering eye drops.
These protective associations persisted at the ten-year time point, suggesting a durable relationship between statin use and reduced need for more invasive glaucoma treatments.
Dr. Weinreb noted that statins’ anti-inflammatory and neuroprotective properties may help preserve optic nerve health, but emphasized that the observational design cannot prove causality. The team called for randomized controlled trials to determine whether statins can be used intentionally as an adjunctive neuroprotective therapy in glaucoma care.
Limitations and next steps
Because the analysis is retrospective and observational, residual confounding is possible. Factors such as socioeconomic status, lifestyle behaviors, adherence to medications, and other unmeasured variables could influence outcomes. The database did not include detailed physiological measures like baseline IOP, visual field metrics, or the clinical reasons for surgery, so it is not possible to confirm whether lower surgical rates reflect milder disease or patient preference.
Despite these limitations, the relatively favorable safety profile, low cost, and global availability of statins make this association an attractive target for prospective trials that could test whether specific statin regimens offer clinically meaningful neuroprotection in glaucoma.
Funding: The research received partial funding from Research to Prevent Blindness.
Editorial notes:
- Article edited by a Neuroscience News editor.
- Journal paper reviewed in full by editorial staff.
- Additional context provided by the reporting team.
About this visual neuroscience and neuropharmacology research
- Media contact: Miles Martin
- Source: UCSD
- Image credit: Image credited to Neuroscience News
- Original research (open access): British Journal of Ophthalmology (Oct 1, 2026). Title: “Statin use is associated with lower risk of open-angle glaucoma incidence and treatment escalation.” Authors: Forest Lin, Alexander T. Hong, Robert N. Weinreb.
- DOI: 10.1136/bjo-2026-330339
Abstract
Statin use is associated with lower risk of open-angle glaucoma incidence and treatment escalation
Background
This retrospective cohort study used a large federated electronic health record database to assess the relationship between statin use and glaucoma outcomes.
Methods
The incidence analysis included adults over 40 with documented statin use and ophthalmologic follow-up within one year prior. The treatment escalation analysis included individuals with glaucoma and concurrent statin exposure. Outcomes measured were incidence of open-angle glaucoma, initiation of topical ocular hypotensives, incisional glaucoma surgery, minimally invasive glaucoma surgery (MIGS), and selective laser trabeculoplasty (SLT).
Results
The incidence cohort comprised 210,701 matched patients and the treatment cohort included 29,598 patients. At five years, statin use was associated with reduced risk of open-angle glaucoma incidence (HR 0.85, 95% CI 0.82–0.89) and lower rates of escalation to incisional surgery (HR 0.64, 95% CI 0.58–0.71), MIGS (HR 0.45, 95% CI 0.41–0.50), and SLT (HR 0.40, 95% CI 0.36–0.44), as well as fewer topical ocular hypotensive prescriptions (HR 0.89, 95% CI 0.86–0.91). At ten years, similar protective associations persisted.
Conclusions
These observational results suggest statin use is associated with lower risk of developing open-angle glaucoma and reduced likelihood of treatment escalation. Prospective randomized trials are needed to clarify causality and determine whether statins can serve as adjuvant neuroprotective therapy in glaucoma management.