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Impact of the use of anti-glaucoma medications on the risk of herpetic keratitis recurrence

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Abstract

Purpose

Numerous case reports have associated anti-glaucoma medications with recurrence of herpes simplex virus (HSV) and herpes zoster virus (HZV) keratitis. The aim of our study was to determine whether different anti-glaucoma agents are associated with recurrence of herpetic keratitis.

Methods

This was a retrospective cohort study using health databases from a Canadian province from January 2001 to December 2012. A new cohort of users on topical prostaglandins (PGs), beta blockers (BBs), alpha-2 agonists (AAs) and carbonic anhydrase inhibitors (CAIs) was created. The date of the third anti-glaucoma drug dispensation within 90 days was deemed the index date of the case. Herpetic keratitis events, as defined by an ICD-9/10 code for HSV or HZV keratitis, or the dispensation of an anti-viral medication by either an ophthalmologist or an optometrist, were examined prior to and following the index date. Risk ratios (RRs) were computed to compare the risk of HSV/HZV keratitis among the PG, BB, AA, and CAI groups individually and collectively while adjusting for age and sex.

Results

Among 19,986 users of glaucoma medications identified, there were 684 cases of HSV/HZV keratitis. There was no increased risk of HSV/HZV keratitis recurrence for any of the four glaucoma medications classes individually or collectively when adjusted for age and sex. There was also no increased risk for redeveloping either HSV keratitis only or HZV keratitis only amongst all anti-glaucoma users.

Conclusion

There is no association between the use of topical ocular hypotensive therapies and HSV/HZV keratitis recurrence. Further studies are needed to confirm these findings.

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Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Ophthalmology and Visual Sciences, Dalhousie University, 2035-2 West Victoria Building, 1276 South Park St, Halifax, NS, B3H 2Y9, Canada

    Bonnie He

  2. Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada

    Hamid Tavakoli

  3. Department of Ophthalmology and Visual Sciences, Cornea Service, Eye Bank of British Columbia, University of British Columbia, 616-2525 Willow Street, Vancouver, BC, V5Z3N8, Canada

    Mahyar Etminan, Shayan Shokoohi, Alfonso Iovieno & Sonia N. Yeung

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  1. Bonnie He
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  2. Hamid Tavakoli
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  4. Shayan Shokoohi
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  5. Alfonso Iovieno
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  6. Sonia N. Yeung
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Contributions

BH: Investigation, Writing – Original Draft, Reviewing/Editing, Visualization. HT: Methodology, Validation, Formal Analysis, Investigation, Data Curation. ME: Conceptualization, Methodology, Validation, Investigation, Data Curation, Resources, Writing – Reviewing/Editing. SS: Conceptualization, Methodology. AI: Conceptualization, Methodology, Investigation, Writing – Reviewing/Editing. SNY: Conceptualization, Methodology, Investigation, Writing – Reviewing/Editing, Project Administration, Supervision.

Corresponding authors

Correspondence to Bonnie He or Sonia N. Yeung.

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Conflict of interest

There are no conflicts of interest. All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors. This study was performed in line with the principles of the Declaration of Helsinki. Approval for the study was obtained by the University of British Columbia’s Clinical Research Ethics Board (H19-01404).

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He, B., Tavakoli, H., Etminan, M. et al. Impact of the use of anti-glaucoma medications on the risk of herpetic keratitis recurrence. Int Ophthalmol 43, 1559–1564 (2023). https://doi.org/10.1007/s10792-022-02552-7

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  • DOI: https://doi.org/10.1007/s10792-022-02552-7

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