Hung-Yu Wang1, Ping-Tao Tseng2, Brendon Stubbs3, Andre F Carvalho4, Dian-Jeng Li5, Tien-Yu Chen6, Pao-Yen Lin7, Yu-Te Hsueh8, Yu-Zhen Chen8, Yen-Wen Chen9, Che-Sheng Chu10. 1. Department of Psychiatry, Tsyr-Huey Mental Hospital, Kaohsiung Jen-Ai's Home, Kaohsiung, Taiwan. 2. WinShine Clinics in Specialty of Psychiatry, Kaohsiung, Taiwan. 3. Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK; Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, De Crespigny Park, London, UK; Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK. 4. Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Centre for Addiction & Mental Health (CAMH), Toronto, ON, Canada. 5. Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Taiwan; Department of Addiction Science, Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan. 6. Department of Psychiatry, School of Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan; Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan. 7. Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, Kaohsiung, Taiwan; Institute for Translational Research in Biomedical Sciences, Kaohsiung Chang Gung Memorial Hospital. 8. Min-Eye Ophthalmology Clinics, Kaohsiung, Taiwan. 9. Prospect Clinic for Otorhinolaryngology & Neurology. 10. Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Center for Geriatric and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan. Electronic address: cschu@vghks.gov.tw.
Abstract
BACKGROUND: The aim of current study was to conduct a systematic review and meta-analysis to explore the relationship between antidepressant use and glaucoma. METHODS: Eight major electronic databases were searched from inception until March 19th, 2018 to obtain relevant studies that evaluated associations of antidepressants [including selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs)] treatment and the risk of primary open-angle glaucoma (POAG) or primary angle-closure glaucoma (PACG) as well as intraocular pressure (IOP), and related anterior chamber parameters compared to participants not exposed to antidepressant treatment. A random-effects meta-analysis was conducted. RESULTS: Six case-control studies and one cohort study were eligible (N = 801,754). The use of SSRIs was not associated with a higher risk of glaucoma (k = 7, pooled adjusted odds ratio (pAOR) = 0.956, 95% confidence interval (CI) = 0.807 to 1.133, p = 0.604). In addition, IOP was lower in participants exposed to antidepressants (SSRIs and SNRIs) (k = 4, Hedges' g = -0.519, 95% CI = -0.743 to -0.296, p < 0.001). Finally, pupillary diameter was higher in participants exposed to antidepressant treatment (k = 4, Hedges' g = 0.681, 95% CI = 0.462 to 0.900, p < 0.001). LIMITATIONS: High heterogeneity of included studies limit the establishment of causal inferences. CONCLUSIONS: This meta-analysis indicates that a putative association between the use of SSRIs and a higher risk of glaucoma remains to be proven. However, antidepressant drug treatment may be associated with significantly lower IOP and higher pupillary diameter. The mechanisms underpinning these associations deserve further investigation.
BACKGROUND: The aim of current study was to conduct a systematic review and meta-analysis to explore the relationship between antidepressant use and glaucoma. METHODS: Eight major electronic databases were searched from inception until March 19th, 2018 to obtain relevant studies that evaluated associations of antidepressants [including selective serotonin reuptake inhibitors (SSRIs) and serotoninnorepinephrine reuptake inhibitors (SNRIs)] treatment and the risk of primary open-angle glaucoma (POAG) or primary angle-closure glaucoma (PACG) as well as intraocular pressure (IOP), and related anterior chamber parameters compared to participants not exposed to antidepressant treatment. A random-effects meta-analysis was conducted. RESULTS: Six case-control studies and one cohort study were eligible (N = 801,754). The use of SSRIs was not associated with a higher risk of glaucoma (k = 7, pooled adjusted odds ratio (pAOR) = 0.956, 95% confidence interval (CI) = 0.807 to 1.133, p = 0.604). In addition, IOP was lower in participants exposed to antidepressants (SSRIs and SNRIs) (k = 4, Hedges' g = -0.519, 95% CI = -0.743 to -0.296, p < 0.001). Finally, pupillary diameter was higher in participants exposed to antidepressant treatment (k = 4, Hedges' g = 0.681, 95% CI = 0.462 to 0.900, p < 0.001). LIMITATIONS: High heterogeneity of included studies limit the establishment of causal inferences. CONCLUSIONS: This meta-analysis indicates that a putative association between the use of SSRIs and a higher risk of glaucoma remains to be proven. However, antidepressant drug treatment may be associated with significantly lower IOP and higher pupillary diameter. The mechanisms underpinning these associations deserve further investigation.
Authors: Carolina Garcia-Villanueva; Elena Milla; José M Bolarin; José J García-Medina; Javier Cruz-Espinosa; Javier Benítez-Del-Castillo; José Salgado-Borges; Francisco J Hernández-Martínez; Elena Bendala-Tufanisco; Irene Andrés-Blasco; Alex Gallego-Martinez; Vicente C Zanón-Moreno; María Dolores Pinazo-Durán Journal: J Clin Med Date: 2022-09-25 Impact factor: 4.964