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Benzodiazepine Use and Risk of Acute Angle-Closure Glaucoma: A Population-Based Case-Crossover Study



Theoretically, benzodiazepines (BZDs) can narrow the iridocorneal angle and induce acute angle-closure glaucoma (AACG). However, little evidence exists regarding this association.


The objective of this study was to assess whether the use of BZDs is associated with the risk of AACG.


We conducted a population-based case-crossover study using the nationwide claims database of the National Health Insurance Service in Korea. Patients with newly diagnosed AACG—between 1 January 2013 and 31 December 2016—who had received at least one BZD prescription prior to AACG diagnosis were enrolled. The date of AACG diagnosis was set as the index date. We assessed BZD use by each patient during a 30-day case period prior to the index date and three consecutive control periods that preceded this date. We used conditional logistic regression that adjusted for concomitant medications to determine the odds ratio for the use of BZDs in the case period compared with that in the control period in patients with incident AACG.


Of the 11,093 patients with incident AACG, 6709 received a prescription for BZD prior to diagnosis. BZD use was associated with an increased risk of AACG [adjusted odds ratio (aOR) = 1.40; 95% confidence interval (CI) 1.27–1.54]. AACG risk was similar for short-acting (aOR = 1.40, 95% CI 1.24–1.57) and long-acting BZDs (aOR = 1.33, 95% CI 1.18–1.50).


We found that BZD use was associated with AACG risk in the Korean population. Clinicians should carefully monitor the occurrence of visual disturbance in BZD-treated patients.

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We would like to acknowledge ophthalmologist Sang Yeop Lee, MD for his invaluable advice during discussions prior to the commencement of the study.

Author information

Correspondence to Ju-Young Shin.

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This study was supported by a grant from the Haesong Geriatric Psychiatry Research Fund of the Korean Mental Health Foundation, Seoul, Republic of Korea. The funding agency was not involved in the study design, data collection and analysis, or manuscript preparation.

Conflict of interest

Woo Jung Kim, Junqing Li, In-Sun Oh, Inmyung Song, Eun Lee, Kee Namkoong, and Ju-Young Shin have no conflicts of interest that are directly relevant to the content of this study.

Data availability statement

The claims database of the National Health Insurance Service used in the study can be accessed at

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Kim, W.J., Li, J., Oh, I. et al. Benzodiazepine Use and Risk of Acute Angle-Closure Glaucoma: A Population-Based Case-Crossover Study. Drug Saf (2020).

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