Antidepressants and risk of cataract development: A population-based, nested case-control study

Chou, Po-Han; Chu, Chih‐Sheng; Chen, Yi Huei; Hsu, Min Yen; Huang, Min; Lan, Tsuo Hung; Lin, Ching Heng

doi:10.1016/j.jad.2017.03.044

Cited by 27 publications

(15 citation statements)

References 38 publications

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“…A cataract is defined as a degradation of the optical quality of the crystalline lens, which affects visual acuity, and can occur in both eyes . Aging, cardiovascular and metabolic diseases, ophthalmic comorbidities, trauma, smoking, ultraviolet‐B light, corticosteroids, and antidepressants are known risk factors …”

Section: Introductionmentioning

confidence: 99%

“…24 Aging, cardiovascular and metabolic diseases, ophthalmic comorbidities, trauma, smoking, ultraviolet-B light, corticosteroids, and antidepressants are known risk factors. [24][25][26] Two meta-analyses including both randomized clinical trials (RCTs) and observational studies did not find consistent evidence demonstrating an increased risk of cataract development in association with the use of statins. 27,28 However, one important limitation of these metaanalyses was the exclusion of a number of observational studies, some of which reporting increased risks.…”

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confidence: 99%

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Statins and risk of cataracts: A systematic review and meta‐analysis of observational studies

Alves

Mendes

Marques

2018

Cardiovascular Therapeutics

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Summary Introduction Two previous meta‐analyses evaluated the risk of cataracts associated with statins, but did not include relevant studies suggesting a cataractogenic effect. Aims The aim of this systematic review and meta‐analysis of observational studies is to evaluate such association considering the latest published evidence. Methods A literature search was conducted to identify observational, comparative studies evaluating the risk of developing cataracts in patients treated with statins. A meta‐analysis was performed to estimate odds ratios (ORs). Results were stratified according to the following studies’ subgroups: design, methodological quality, method of diagnosis of cataract, patients’ age, and median follow‐up. Meta‐regressions evaluated the influence of the following risk factors: smoking, hypertension, corticosteroids, selective serotonin reuptake inhibitors (SSRI), diabetes mellitus, and cardiovascular disease. Results Twenty‐one studies were included. Treatment with statins was associated with an increased risk of cataracts [OR: 1.11 (95% CI: 1.02‐1.21); P = 0.017; I2 = 97.5%]. This risk remained statistically significant among case‐controls, good methodological quality studies, studies with length of follow‐up ≥5 years and those which outcome was cataract surgery. Between‐studies heterogeneity was high among all risk estimates. Meta‐regressions identified an inverse relationship between the risk of cataracts and the proportion of diabetic patients in the studies. Conclusions The results point out an increased risk of cataract development with statins. However, since the magnitude of the effect is low and between‐studies heterogeneity is high, the extent in which these results have impact on the benefit/risk ratio of statins is difficult to ascertain due to the uncertainty of the findings.

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Section: Introductionmentioning

confidence: 99%

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confidence: 99%

Statins and risk of cataracts: A systematic review and meta‐analysis of observational studies

Alves

Mendes

Marques

2018

Cardiovascular Therapeutics

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“…1 . Seven studies [ 6 – 9 , 15 – 17 ] were finally included in this meta-analysis. Of these, five studies were performed in North America, one in Europe, and one in Asia.…”

Section: Resultsmentioning

confidence: 99%

Antidepressants use and risk of cataract development: a systematic review and meta-analysis

Dai

Zhu

et al. 2018

BMC Ophthalmol

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BackgroundEpidemiological studies suggest that antidepressants use may increase the risk of cataract, but the results are inconclusive. We aimed to examine this association by performing a systematic review and meta-analysis.MethodsRelevant studies were identified by searching PubMed and Web of Science databases through June 2017. We included studies that reported risk estimates for the association between antidepressants use and cataract risk. A random-effects model was used to calculate the summary odds ratio (OR) with its 95% confidence interval (CI).ResultsWe identified seven studies of antidepressants use and risk of cataract involving 447,672 cases and 1,510,391 controls. Overall, the combined ORs (95% CIs) of cataract for selective serotonin reuptake inhibitors (SSRIs), serotonin noradrenalin reuptake inhibitors (SNRIs), and tricyclic antidepressants (TCAs) were 1.12 (1.06–1.19), 1.13 (1.04–1.24), and 1.19 (1.11–1.28), respectively. A certain degree of heterogeneity was observed across studies (P < 0.001, I2 = 92.2% for SSRIs, P = 0.026, I2 = 67.5% for SNRIs, and P = 0.092, I2 = 58.0% for TCAs).ConclusionThis meta-analysis provides evidence of a significant positive association between antidepressants use and risk of cataract. Because of the heterogeneity and limited eligible studies, further prospective studies are warranted to confirm the preliminary findings of our study.

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“…One study examined the association between antipsychotic use and cataract, 5 and another examined the association between statin use and cataract 6 ; adjusting for confounding variables related only to the primary analyses and not to the context of antidepressant use. Of the remaining 4 studies, only 1 undertook propensity score matching 7 ; the rest 8-10 adjusted only for a few cataract risk factors. In other words, if depression and the correlates thereof are a risk factor for cataract, confounding by indication was not addressed in the studies that were subjected to meta-analysis.…”

Section: E2mentioning

confidence: 99%

Antidepressants, Mood Stabilizers, Antipsychotics, and the Risk of Cataract

Andrade

2019

J. Clin. Psychiatry

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Depression and Eye Diseases Zheng et al 1 described a systematic review and meta-analysis of depression and depressive symptoms in patients with eye diseases. They identified 28 relevant studies (pooled N = 6,589) and estimated that the prevalence of depression or depressive symptoms was 25% (95% CI, 20%-30%) in the pooled sample. The highest prevalence was found in patients with xerophthalmia (29%). The prevalence was also high in patients with glaucoma (25%), age-related macular degeneration (24%), and cataract (23%). Patients with eye disease were at higher risk of depression or depressive symptoms than healthy controls (odds ratio [OR], 1.59; 95% confidence interval [CI], 1.40-1.81). It is possible that the depression in patients with eye disease is a reaction to the ocular symptoms, and it is possible that the depression and eye disease occur coincidentally. It is also possible that depression and its correlates are a risk factor for at least some eye diseases. In this context, one possibility is that the antidepressant drugs used to treat depression increase the risk of cataract. Cataract Cataract is a disease of the eye that is characterized by impairment of vision resulting from the development of opacities in the lens. Cataract is the leading cause of blindness in low and middle income countries. The prevalence of cataract is about 4% in persons who are around 60 years of age and > 90% in those who are 80 years and older. Risk factors for cataract include older age, female sex, genetic vulnerabilities, lifestyle behaviors, medical comorbidities, and many others. 2 Psychotropic drugs, particularly antidepressant drugs, have recently been associated with cataract. This article critically examines the literature on the subject. Antidepressant Drugs and Cataract: Meta-Analysis Fu et al 3 described a systematic review and meta-analysis of studies that examined the development of cataract after antidepressant use. They searched electronic databases, reference lists, and other sources and identified 7 relevant case-control studies; 3 had been conducted in the United States, 2 in Canada, and 1 each in the United Kingdom and Taiwan. The pooled sample included 447,672 cases and 1,510,391 controls. Important findings from the meta-analysis 3 are presented in Table 1. In short, selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, and tricyclic antidepressants were each associated with a small but statistically significant increase in the risk of cataract. All 3 analyses were characterized by substantial heterogeneity; the authors did not examine the source of the heterogeneity. Among individual antidepressant drugs, the risk was significant for citalopram, fluoxetine, fluvoxamine, and venlafaxine but not for paroxetine, sertraline, escitalopram, duloxetine, and milnacipran; it is possible that many analyses were underpowered for the individual drugs. Visual inspection of the funnel plot suggested clear publication bias.

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Antidepressants and risk of cataract development: A population-based, nested case-control study

Cited by 27 publications

References 38 publications

Statins and risk of cataracts: A systematic review and meta‐analysis of observational studies

Statins and risk of cataracts: A systematic review and meta‐analysis of observational studies

Antidepressants use and risk of cataract development: a systematic review and meta-analysis

Antidepressants, Mood Stabilizers, Antipsychotics, and the Risk of Cataract

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