Study register / Autonomic / Other / Glaucoma

Glaucoma

3 curated studies · 3 key studies · mechoulam.de

Cannabis is reported to lower intraocular pressure only briefly and to be unsuitable as a glaucoma therapy. A genetic analysis found no causal association between cannabis use and glaucoma.

Rating scheme

The letter rates the quality of a study, independently of its type. Every study type can receive any grade: a review can be B or C when it is small or weak, and an RCT can be S. The grade is a synthesis of study design, journal authority and clinical bindingness:

S
Highest evidence, large, methodologically first-rate studies or S3 guidelines
A
Strong evidence, solid, meaningful studies with a clear result
B
Moderate evidence, smaller or methodologically limited studies
C
Weak evidence, preliminary, indirect or contradictory findings
D
Lowest evidence, exploratory hints, single cases or expert opinion

Quality profile per study

To the left of each study there is a profile of four features, it shows the differences within a letter class.

Sample size ★
Number of participants (RCT) or included studies (review).
Blinding
Double-blind, single-blind or open-label.
Effect size
Clear benefit, mixed, no benefit or harm.
Citations / year ★
Age-adjusted citation frequency.

Key studies

3
  1. 01
    A
    Cannabis use and the risk of primary open-angle glaucoma: a Mendelian randomization study.
    Katsimpris et al. ·2023 ·Scientific reports
    Read
  2. 02
    B
    The Effect of Orally Administered Dronabinol on Optic Nerve Head Blood Flow in Healthy Subjects-A Randomized Clinical Trial.
    Hommer et al. ·2020 ·Clinical pharmacology and therapeutics
    Read
  3. 03
    B
    Single oral administration of dronabinol increases ocular blood flow in patients with glaucoma.
    Lindner et al. ·2026 ·Acta ophthalmologica
    Read

Systematic Reviews and Meta-Analyses

Syntheses of RCT evidence following Cochrane and PRISMA standards.

1
A
Sample size —
Blinding —
Effect size No benefit
Citations / year ★★★★★
● Key study
Katsimpris et al. ·2023 ·Scientific reports
4 citations

Cannabis use and the risk of primary open-angle glaucoma: a Mendelian randomization study.

Design
Meta-Analyse
Sample
n = 216.257 Pat. (gepoolt)
Key finding

Mendelian randomisation analysis shows no evidence of a causal relationship between cannabis use and primary open-angle glaucoma.

Summary

Mendelian randomisation study on cannabis and primary open-angle glaucoma (POAG); n=16.677 cases + 199.580 controls. No causal association between lifetime cannabis use and POAG (OR=1.04, 95% CI 0.88–1.23) or cannabis use disorder and POAG (OR=0.97, 95% CI 0.92–1.03). Sensitivity analyses confirm the null finding.

DOI 10.1038/s41598-023-45872-z ↗

Randomised Controlled Trials

Efficacy and safety evidence from controlled interventional trials.

2
B
Sample size ★★★★★
Blinding Double-blind
Effect size Clear benefit
Citations / year ★★★★★
● Key study
Hommer et al. ·2020 ·Clinical pharmacology and therapeutics
14 citations

The Effect of Orally Administered Dronabinol on Optic Nerve Head Blood Flow in Healthy Subjects-A Randomized Clinical Trial.

Design
RCT
Sample
n = 24 Pat.
Key finding

Dronabinol significantly increased optic nerve head blood flow (ONHBF) by 9,5% at rest, while placebo showed no effect.

Summary

n=24 healthy subjects, randomised, placebo-controlled crossover study of 5 mg dronabinol (synthetic THC) oral. Primary finding: dronabinol increased Optic Nerve Head Blood Flow (ONHBF) at rest by 9,5±8,1% vs. baseline (placebo 0,3±7,4%, p<0,001 between study days). No effect on IOP, MAP or Ocular Perfusion Pressure (OPP); no psychoactive side effects. Autoregulatory response of ONHBF to isometric exercise unchanged. Well tolerated; translation to glaucoma patients still pending.

DOI 10.1002/cpt.1797 ↗
B
Sample size ★★★★★
Blinding Double-blind
Effect size Clear benefit
Citations / year ★★★★★
● Key study
Lindner et al. ·2026 ·Acta ophthalmologica
0 citations

Single oral administration of dronabinol increases ocular blood flow in patients with glaucoma.

Design
RCT
Sample
n = 23 Pat.
Key finding

A single dose of 10 mg dronabinol significantly increased optic nerve head blood flow by approximately 10-12% without effects on intraocular pressure or blood pressure.

Summary

n=23 patients with primary open-angle glaucoma (POAG), randomized double-blind cross-over dronabinol (5 mg vs. 10 mg) vs. placebo. 10 mg dronabinol significantly increased optic nerve head blood flow (ONHBF) (MA +10.8±20.6%, p=0.018; MV +12.0±24.8%, p=0.042; MT +11.0±22.6%, p=0.022 vs. placebo) up to 4 h post-administration, without affecting IOP or blood pressure (p>0.548). Vessel density in the superficial vascular plexus +6.7±14.7% (p=0.040 vs. 5 mg).

DOI 10.1111/aos.17573 ↗