CJO January 2025: Featured Highlights on Glaucoma

The following CJO Highlight summarizes key findings from the journal article “Acute Angle-Closure Glaucoma Risk: A Comparative Study of Escitalopram and Antidepressants.”¹

Acute angle-closure glaucoma (AACG) is an ophthalmic emergency that has been linked to selective serotonin reuptake inhibitors (SSRIs) due to their mild anticholinergic effect and possibility of mydriasis. Escitalopram, one of the most prescribed SSRIs, has been implicated in the risk of AACG in case reports. However, prior to this CJO study by Khan et al., it remained unclear whether AACG secondary to escitalopram is a class effect or carries a higher risk than other SSRIs. The highlighted study investigated whether escitalopram poses a greater risk of AACG compared to other SSRIs or non-SSRI antidepressants. A total of 865,546 subjects were included to assess the incidence of AACG among new users of citalopram, escitalopram, sertraline, and venlafaxine. Results indicated trends toward a lower AACG risk in users of citalopram, escitalopram, and venlafaxine compared with sertraline, though none of these differences reached statistical significance. Findings suggest that escitalopram may be associated with a reduced risk of AACG, but further research with larger cohorts is needed. Clinicians should remain cautious when prescribing antidepressants, particularly for patients at risk of glaucoma.

To access the full article, please follow the link below:

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Reference:

1. Khan HM, Schendel S, Mikelberg FS, Etminan M. Acute angle-closure glaucoma risk: a comparative study of escitalopram and antidepressants. Can J Ophthalmol. 2025 Jan 24:S0008-4182(25)00004-3. doi: 10.1016/j.jcjo.2025.01.004. Epub ahead of print. PMID: 39870359.

Submitted by: Audrey-Anne Lapierre
Reviewed and Approved by: Anne Xuan-Lan Nguyen, MD