Androgen deprivation therapy may reduce the risk of primary open-angle glaucoma in patients with prostate cancer: a nationwide population-based cohort study

Abstract

Background We evaluated the risk of developing primary open-angle glaucoma (POAG) according to androgen deprivation therapy (ADT) status in patients with prostate cancer. Materials and methods From the nationwide claims database in South Korea, 218,203 men with prostate cancer were identified between 2008 and 2017. After applying the inclusion and exclusion criteria, a total of 170,701 patients (42,877 in the ADT and non-ADT groups and 127,824 in the non-ADT group) were included in the analysis. To adjust for comorbidities between cohorts, exact matching was performed. Cox proportional hazard regression models were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of POAG associated with ADT after controlling for potential confounding factors. Results In the matched cohort, the ADT group had a lower proportion of newly developed POAG than the non-ADT group (2.10% vs. 2.88%, respectively; P < 0.0001). Multivariable analysis revealed that the ADT group had a significantly lower risk of POAG than the non-ADT group (HR, 0.808; 95% CI, 0.739–0.884; P < 0.0001). The risk of POAG was lower in patients who underwent ADT for less than 2 years (HR, 0.782; 95% CI, 0.690–0.886; P = 0.0001) and in those receiving ADT for over 2 years (HR, 0.825; 95% CI, 0.744–0.916; P = 0.0003) compared with the non-ADT group. Conclusions The use of ADT was associated with a decreased risk of POAG in Korean patients with prostate cancer. Our findings suggest that testosterone may be involved in the pathophysiology of POAG, and this should be confirmed through further studies.

The Use of Androgen Deprivation Therapy for Prostate Cancer Lead to Similar Rate of Following Open Angle Glaucoma: A Population-Based Cohort Study

“…To our knowledge, few papers have demonstrated this finding before. Only a study conducted in the Korean population demonstrated a significantly lower incidence of OAG in prostate cancer patients who received ADT compared to the prostate cancer patients who did not deceive ADT [20]. The results between that study and our study were similar while the study interval in our study was about two-fold compared to the previous study and could declare the long-term effect of ADT on OAG decrement [20].…”

“…Only a study conducted in the Korean population demonstrated a significantly lower incidence of OAG in prostate cancer patients who received ADT compared to the prostate cancer patients who did not deceive ADT [20]. The results between that study and our study were similar while the study interval in our study was about two-fold compared to the previous study and could declare the long-term effect of ADT on OAG decrement [20]. In addition, the high level of urbanization is a predicting factor for glaucoma development which we adjusted in our multivariable analysis [35].…”

“…Moreover, the correlation between OAG and ischemic stroke or coronary heart disease had been demonstrated in previous researches [17,18]. ADT can lead to a higher rate of cardiovascular disorders and related mortality [19], and a previous study showed that the incidence of OAG decreased in prostate cancer patients who received ADT therapy [20]. Accordingly, ADT may have the chance to alter the rate of OAG; however, further research is needed to confirm this.…”

Genetic variation reveals the influence of steroid hormones on the risk of retinal neurodegenerative diseases

“…There is a gap in current research on T’s role in the glaucomatous process. A cohort study in Korea showed that the use of androgen deprivation therapy was associated with a decreased risk of POAG patients with prostate cancer ( 46 ). Bailey et al.…”

Higher testosterone is associated with open-angle glaucoma in women: a genetic predisposition?

“…The direct association between testosterone levels and glaucoma has not been investigated yet in men. However, one recent study investigated the effects of androgen-deprivation therapies (ADT) on primary OAG [ 43 ]. They found that ADT in men with prostate cancer reduced the risk of primary OAG, suggesting that reducing testosterone levels may protect against primary OAG.…”