The Effect of Intraocular Pressure-Lowering Medication on Metastatic Uveal Melanomas

Background: There has been speculation that IOP-lowering medication, which increases aqueous humor outflow, increases the risk of metastatic uveal melanoma (UM). This hypothesis has not been studied previously but is relevant for UM patients who use IOP-lowering medication. The aim of the current st...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Jan Pals, Hanneke W. Mensink, Erwin Brosens, Robert M. Verdijk, Nicole C. Naus, Dion A. Paridaens, Emine Kilic, Wishal D. Ramdas
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	glaucoma uveal melanoma intraocular pressure intraocular pressure-lowering medication metastatic uveal melanoma Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/528cb63cc9bf47298a91c8caf005a8d0
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:528cb63cc9bf47298a91c8caf005a8d0
record_format	dspace
spelling	oai:doaj.org-article:528cb63cc9bf47298a91c8caf005a8d02021-11-25T17:02:16ZThe Effect of Intraocular Pressure-Lowering Medication on Metastatic Uveal Melanomas10.3390/cancers132256572072-6694https://doaj.org/article/528cb63cc9bf47298a91c8caf005a8d02021-11-01T00:00:00Zhttps://www.mdpi.com/2072-6694/13/22/5657https://doaj.org/toc/2072-6694Background: There has been speculation that IOP-lowering medication, which increases aqueous humor outflow, increases the risk of metastatic uveal melanoma (UM). This hypothesis has not been studied previously but is relevant for UM patients who use IOP-lowering medication. The aim of the current study is to assess the association between the use of intraocular pressure (IOP)-lowering medication and the risk of metastatic UM, and mortality. Methods: A retrospective cohort study, in which patients from the Rotterdam Ocular Melanoma Study were included from 1986 onwards. Medical records were evaluated for use of IOP-lowering medication at baseline (i.e., before diagnosis). For each IOP-lowering medication, we divided patients into two groups for comparison (e.g., patients with alpha2-agonist use and patients without alpha2-agonist use). All patients underwent regular ophthalmic examinations and routine screening for metastasis. Survival analyses were initiated to compare groups in each IOP-lowering medication group. In addition, secondary analyses were performed to examine the association between IOP and the development of metastatic UM, and mortality. Results: A total of 707 patients were included of whom 13 patients used prostaglandin or pilocarpine at baseline. For alpha2-agonist, beta-blocker, carbonic anhydrase inhibitor, and oral IOP-lowering medication these were 4, 14, 11, and 12 patients, respectively. The risk of metastatic UM (choroid and ciliary body melanoma) among the prostaglandin/pilocarpine users was significantly higher than controls (HR [95% CI]: 4.840 [1.452–16.133]). Mortality did not differ significantly among the IOP-lowering medications groups, except for the prostaglandin or pilocarpine group (HR [95% CI]: 7.528 [1.836–30.867]). If we combined all IOP-lowering medication that increase aqueous humor outflow, the risk (HR [95% CI]) of metastatic UM and mortality was 6.344 (1.615–24.918) and 9.743 (2.475–38.353), respectively. There was an association between IOP and mortality, but not for the onset of metastatic UM. Conclusion: The use of topical prostaglandin or pilocarpine may increase the risk of metastatic UM and mortality compared to patients without prostaglandin or pilocarpine use. Therefore, use of IOP-lowering medication which increases aqueous humor outflow, should be avoided in patients with (presumed) UM.Jan PalsHanneke W. MensinkErwin BrosensRobert M. VerdijkNicole C. NausDion A. ParidaensEmine KilicWishal D. RamdasMDPI AGarticleglaucomauveal melanomaintraocular pressureintraocular pressure-lowering medicationmetastatic uveal melanomaNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENCancers, Vol 13, Iss 5657, p 5657 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	glaucoma uveal melanoma intraocular pressure intraocular pressure-lowering medication metastatic uveal melanoma Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	glaucoma uveal melanoma intraocular pressure intraocular pressure-lowering medication metastatic uveal melanoma Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Jan Pals Hanneke W. Mensink Erwin Brosens Robert M. Verdijk Nicole C. Naus Dion A. Paridaens Emine Kilic Wishal D. Ramdas The Effect of Intraocular Pressure-Lowering Medication on Metastatic Uveal Melanomas
description	Background: There has been speculation that IOP-lowering medication, which increases aqueous humor outflow, increases the risk of metastatic uveal melanoma (UM). This hypothesis has not been studied previously but is relevant for UM patients who use IOP-lowering medication. The aim of the current study is to assess the association between the use of intraocular pressure (IOP)-lowering medication and the risk of metastatic UM, and mortality. Methods: A retrospective cohort study, in which patients from the Rotterdam Ocular Melanoma Study were included from 1986 onwards. Medical records were evaluated for use of IOP-lowering medication at baseline (i.e., before diagnosis). For each IOP-lowering medication, we divided patients into two groups for comparison (e.g., patients with alpha2-agonist use and patients without alpha2-agonist use). All patients underwent regular ophthalmic examinations and routine screening for metastasis. Survival analyses were initiated to compare groups in each IOP-lowering medication group. In addition, secondary analyses were performed to examine the association between IOP and the development of metastatic UM, and mortality. Results: A total of 707 patients were included of whom 13 patients used prostaglandin or pilocarpine at baseline. For alpha2-agonist, beta-blocker, carbonic anhydrase inhibitor, and oral IOP-lowering medication these were 4, 14, 11, and 12 patients, respectively. The risk of metastatic UM (choroid and ciliary body melanoma) among the prostaglandin/pilocarpine users was significantly higher than controls (HR [95% CI]: 4.840 [1.452–16.133]). Mortality did not differ significantly among the IOP-lowering medications groups, except for the prostaglandin or pilocarpine group (HR [95% CI]: 7.528 [1.836–30.867]). If we combined all IOP-lowering medication that increase aqueous humor outflow, the risk (HR [95% CI]) of metastatic UM and mortality was 6.344 (1.615–24.918) and 9.743 (2.475–38.353), respectively. There was an association between IOP and mortality, but not for the onset of metastatic UM. Conclusion: The use of topical prostaglandin or pilocarpine may increase the risk of metastatic UM and mortality compared to patients without prostaglandin or pilocarpine use. Therefore, use of IOP-lowering medication which increases aqueous humor outflow, should be avoided in patients with (presumed) UM.
format	article
author	Jan Pals Hanneke W. Mensink Erwin Brosens Robert M. Verdijk Nicole C. Naus Dion A. Paridaens Emine Kilic Wishal D. Ramdas
author_facet	Jan Pals Hanneke W. Mensink Erwin Brosens Robert M. Verdijk Nicole C. Naus Dion A. Paridaens Emine Kilic Wishal D. Ramdas
author_sort	Jan Pals
title	The Effect of Intraocular Pressure-Lowering Medication on Metastatic Uveal Melanomas
title_short	The Effect of Intraocular Pressure-Lowering Medication on Metastatic Uveal Melanomas
title_full	The Effect of Intraocular Pressure-Lowering Medication on Metastatic Uveal Melanomas
title_fullStr	The Effect of Intraocular Pressure-Lowering Medication on Metastatic Uveal Melanomas
title_full_unstemmed	The Effect of Intraocular Pressure-Lowering Medication on Metastatic Uveal Melanomas
title_sort	effect of intraocular pressure-lowering medication on metastatic uveal melanomas
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/528cb63cc9bf47298a91c8caf005a8d0
work_keys_str_mv	AT janpals theeffectofintraocularpressureloweringmedicationonmetastaticuvealmelanomas AT hannekewmensink theeffectofintraocularpressureloweringmedicationonmetastaticuvealmelanomas AT erwinbrosens theeffectofintraocularpressureloweringmedicationonmetastaticuvealmelanomas AT robertmverdijk theeffectofintraocularpressureloweringmedicationonmetastaticuvealmelanomas AT nicolecnaus theeffectofintraocularpressureloweringmedicationonmetastaticuvealmelanomas AT dionaparidaens theeffectofintraocularpressureloweringmedicationonmetastaticuvealmelanomas AT eminekilic theeffectofintraocularpressureloweringmedicationonmetastaticuvealmelanomas AT wishaldramdas theeffectofintraocularpressureloweringmedicationonmetastaticuvealmelanomas AT janpals effectofintraocularpressureloweringmedicationonmetastaticuvealmelanomas AT hannekewmensink effectofintraocularpressureloweringmedicationonmetastaticuvealmelanomas AT erwinbrosens effectofintraocularpressureloweringmedicationonmetastaticuvealmelanomas AT robertmverdijk effectofintraocularpressureloweringmedicationonmetastaticuvealmelanomas AT nicolecnaus effectofintraocularpressureloweringmedicationonmetastaticuvealmelanomas AT dionaparidaens effectofintraocularpressureloweringmedicationonmetastaticuvealmelanomas AT eminekilic effectofintraocularpressureloweringmedicationonmetastaticuvealmelanomas AT wishaldramdas effectofintraocularpressureloweringmedicationonmetastaticuvealmelanomas
_version_	1718412774791446528

The Effect of Intraocular Pressure-Lowering Medication on Metastatic Uveal Melanomas

Ejemplares similares