Association Between Alpha-Blockers for Angle-Closure Glaucoma

Abstract

center dot OBJECTIVE: To investigate the association between alpha ( a)-blockers use for benign prostatic hyperplasia (BPH) and the incidence of acute angle-closure glaucoma center dot PARTICIPANTS: This study analyzed data from the Kopassing nationwide health records from 2002 to 2022. A 1:5 propensity score-matched cohort was created using baseline covariates, ensuring balance between AACG cases and matched controls. center dot METHODS: Alpha-blocker use for BPH was identified by the presence of both a BPH diagnosis (KCD code N40) and a corresponding prescription prior to AACG diagnosis. Patients were categorized into three groups based on cumulative medication duration: Category 1 ( <= 23 days), Category 2 (24-202 days), and Category 3 center dot MAIN OUTCOMES AND MEASURES: Incident AACG cases were identified using diagnostic and procedure codes, and hazard ratios (HR) were estimated using Cox proportional hazards models. center dot RESULTS: The final cohort included 30 450 participants, comprising 5075 AACG cases and 25 375 matched controls. Alpha-blocker use was associated with a significantly increased risk of AACG (adjusted HR, nonuse. A dose-response relationship was observed, with AACG incidence increasing from 0.15% among users with <= 23 days of exposure to 0.41% among those with >= 203 days. center dot CONCLUSIONS: This study demonstrates a significant, duration-dependent association between a-blocker use for BPH and an increased risk of AACG. These find-ings underscore the potential value of ophthalmologic evaluation when prescribing a-blockers, particularly for patients who may be anatomically predisposed to angle-closure events. (Am J Ophthalmol 2026;282: 197-205. (c) 2025 Elsevier Inc. All rights are reserved, includ-ing those for text and data mining, AI training, and similar technologies.)