Association between Open-Angle Glaucoma and Cocaine Use

Cocaine has been shown to change intraocular fluid dynamics in animal studies. Researchers conducted a cross-sectional comparison study using diagnostic codes and prescription history from a national Department of Veterans Affairs (VA) database to determine whether persons with cocaine abuse or dependence were more likely to have a diagnosis of open-angle glaucoma than a comparable population with no cocaine use. Of 5,373,205 VA enrollees who made outpatient visits in 2009, 82,900 (1.5%) had open-angle glaucoma and 177,929 (3.3%) had cocaine use or dependence. Analyses adjusted for age, race/ethnicity, gender, and other drug use were limited to subjects with complete information.

• Among patients with primary open-angle glaucoma, the mean age of those with cocaine abuse or dependence was 54 years, while the mean age of those without was 73 years.

• Men with cocaine abuse or dependence were more likely to have a diagnosis of open-angle glaucoma (adjusted odds ratio [AOR), 1.45). No association was detected among women (AOR, 0.98).

Comments:

These results provide some evidence supporting cocaine as a glaucoma risk factor in men. It is not clear why this association would be present in men and not in women. Further study is warranted to confirm this association and determine whether cocaine-associated glaucoma might be reversible.

Alexander Y. Walley, MD, MSc

Reference:

French DD, Margo CE, Harman LE. Substance use disorder and the risk of open-angle glaucoma. J Glaucoma. 2011;20(7):452–457.