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Atypical antipsychotic use and the risk of cataract surgery: a nested case-control study

Session Details

Session Title: Ocular pathologies and training and innovation

Session Date/Time: Monday 07/10/2013 | 08:00-10:00

Paper Time: 08:50

Venue: Emerald (First Floor)

First Author: : K.Pakzad-Vaezi CANADA

Co Author(s): :    M. Etminan   F. Mikelberg           

Abstract Details

Purpose:

Although the risk of cataracts with the use of conventional antipsychotics is well known, the association between cataracts and the newer, "atypical" antipsychotics is less well established. Given the increasing use and broader indications for this class of medications, this study was conducted to further investigate cataract risk associated with the use of atypical antipsychotics.

Setting:

British Columbia, Canada

Methods:

A large health claims database (The British Columbia Linked Health Database) from British Columbia, Canada was used from January 2000 to December 2007 for this retrospective nested case-control study. Cases were defined as clinically significant cataracts requiring surgery, and were identified using cataract surgery procedure codes. For each case, four controls were randomly selected using a density based sampling approach and matched to cases by age and calendar time. Rate ratios were calculated for users of atypical and typical antipsychotics adjusting for known cataractogenic factors.

Results:

162,501 cases of cataract surgery and 650,004 controls were included. The adjusted rate ratio (aRR) for current users of atypical antipsychotics was 0.84 (95% CI, 0.80-0.89) compared to none users. A greater number of prescriptions filled in the year prior to cataract surgery, compared to the median number of filled prescriptions, was associated with a lower cataract surgery rate (aRR, 0.70; 95% CI, 0.65-0.75) than those with fewer prescriptions filled (aRR, 0.85; 95% CI, 0.79-0.91).

Conclusions:

A protective association between the use of atypical antipsychotics and risk of clinically significant cataracts requiring surgery was established. Potential bio- and neurochemical mechanisms for this protective effect are discussed.

Financial Interest:

NONE