Effect of telmisartan on intraocular pressure

Objective: The aim of this study was to evaluate the effects of systemic telmisartan use on visual acuity (VA), intraocular pressure (IOP), retinal nerve fiber layer (RNFL), retinal ganglion cells (RGC), visual field (VF) and anterior segment parameters. Methods: A total of 134 eyes of 67 patients, 33 with glaucoma and 34 without glaucoma, who were started on telmisartan for hypertension and microalbuminuria were included in the study. Mean arterial pressure (MAP), VA, diurnal IOP measurement, cup-to-disc ratio, RNFL and RGC analysis, GA test (Humphrey 24-2) and optic biometry were performed before treatment and at 3 and 6 months. Results: A significant decrease in MAP was observed in both groups (p<0.001). In the glaucoma group, there was a significant decrease in VA at 6 months (p=0.001), and a decreasing trend was observed in and RGC values, but not statistically significant (p=0.053; p=0.076). There was no significant difference between the groups in visual field parameters and IOP values (p>0.05). Conclusion: Although telmisartan effectively lowers MAP, it did not show a significant effect on IOP or RNFL. Additional well-designed clinical studies using topical formulations are needed to clarify its potential role in glaucoma treatment. Keywords: Glaucoma, intraocular pressure, renin–angiotensin system, retinal nerve fiber layer, telmisartan