{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T18:07:13Z","timestamp":1789150033244,"version":"build-2803163510"},"reference-count":40,"publisher":"BMJ","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000615","name":"Fight for Sight UK","doi-asserted-by":"publisher","award":["24\/UGUK21"],"award-info":[{"award-number":["24\/UGUK21"]}],"id":[{"id":"10.13039\/501100000615","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Institute for Health Research to Moorfields Eye Hospital and the UCL Institute of Ophthalmology for a Biomedical Research Centre","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}]},{"name":"Richard Desmond Charitable Trust","award":["Not applicable"],"award-info":[{"award-number":["Not applicable"]}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["224390\/Z\/21\/Z"],"award-info":[{"award-number":["224390\/Z\/21\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2026,8,14]]},"abstract":"<jats:sec>\n                    <jats:title>Background\/aims<\/jats:title>\n                    <jats:p>Primary open-angle glaucoma (POAG) is a leading cause of irreversible sight loss worldwide. A vascular mechanism has been proposed in POAG pathogenesis but supporting evidence remains limited. This study examined whether treatment for erectile dysfunction (ED), a condition with known vascular associations, is linked to POAG risk in men.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective nested case\u2013control study used nationally representative UK primary care data from Clinical Practice Research Datalink (CPRD) Gold and CPRD Aurum. Cases diagnosed with POAG (n=218 056) were matched 4:1 by age and primary care practice to controls without glaucoma diagnosis or treatment (n=876 872). Conditional logistic regression estimated odds ratios (ORs) and 95% CIs for the association between ED medication use and POAG risk, adjusted for age, ethnicity and deprivation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Mean age was 69 years in cases and 68 years in controls. ED medications were prescribed in 20% of cases versus 17% of controls. ED medication use was associated with significantly higher POAG risk (OR 1.29, 95% CI 1.25 to 1.32 in CPRD Gold; OR 1.17, 95% CI 1.15 to 1.18 in CPRD Aurum). Older age and Black or Asian ethnicity were consistently associated with increased risk. Hypertension, diabetes, asthma, migraine and sickle cell disease were additional risk factors, while myocardial infarction and angina were associated with lower risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>ED medication use was prospectively associated with higher POAG risk. The on-demand nature of ED medication use suggests a vascular rather than direct pharmacological mechanism. Experimental studies examining vasoactive medications and POAG outcomes are needed to confirm these findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjo-2026-330115","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T17:20:10Z","timestamp":1789147210000},"page":"bjo-2026-330115","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Erectile dysfunction and the risk of glaucoma in men: a prospective nested case\u2013control study using large-scale UK primary care data"],"prefix":"10.1136","author":[{"given":"Ruolan","family":"Fan","sequence":"first","affiliation":[{"name":"Institute of Health Informatics, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arturo","family":"Gonzalez-Izquierdo","sequence":"additional","affiliation":[{"name":"Institute of Health Informatics, University College London, London, UK"},{"name":"Department of Applied Health Science, University of Birmingham, Birmingham, UK"},{"name":"National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research, Institute of Translational Medicine, Birmiingham, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Qummer Ul Arfeen","sequence":"additional","affiliation":[{"name":"Institute of Health Informatics, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0800-2890","authenticated-orcid":false,"given":"Alasdair","family":"Warwick","sequence":"additional","affiliation":[{"name":"NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelsey V","family":"Stuart","sequence":"additional","affiliation":[{"name":"NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuin","family":"Ying Ung","sequence":"additional","affiliation":[{"name":"St John\u2019s Institute of Dermatology, King\u2019s College London, London, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie K","family":"Fitzpatrick","sequence":"additional","affiliation":[{"name":"Institute of Health Informatics, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6802-8585","authenticated-orcid":false,"given":"Anthony","family":"Khawaja","sequence":"additional","affiliation":[{"name":"NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0369-8574","authenticated-orcid":false,"given":"Alicja R","family":"Rudnicka","sequence":"additional","affiliation":[{"name":"School of Health and Medical Sciences, City St George\u2019s, University of London, London, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4755-177X","authenticated-orcid":false,"given":"Paul J","family":"Foster","sequence":"additional","affiliation":[{"name":"NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1135-5977","authenticated-orcid":false,"given":"Christopher G","family":"Owen","sequence":"additional","affiliation":[{"name":"School of Health and Medical Sciences, City St George\u2019s, University of London, London, England, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"2026091110200781000_bjo-2026-330115v1.1","unstructured":"GBD 2019 Blindness Causes Collaborators, Vision Impairment Collaborators, Vision Loss Expert Group of the Global Burden of Disease Study . 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