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Text sizeBirmingham, AL - Statins may help prevent the eye disease macular degeneration, according to a new study published in the September 2003 issue of the British Journal of Ophthalmology.1
Macular degeneration, the leading cause of irreversible vision loss among older adults, is caused by the progressive breakdown of cells in the macula, located in the center of the retina. Risk increases with age, and as yet there is no effective curative or preventive treatment. Smokers are thought to be more susceptible.
The authors of the current paper, led by Dr Gerald McGwin (University of Alabama at Birmingham), explain that risk factors for macular degeneration have focused on smoking, alcohol consumption, diet, hypertension, and diabetessimilar to the risk factors for cardiovascular disease, which has led to suggestions that the pathophysiology of these diseases may be similar.
They further note that the prominent histopathological and clinical lesions in macular degeneration contain abundant lipids, including cholesterol, leading to the possibility that cholesterol-lowering agents may have a role in the treatment or prevention of the condition.
To look at this in more detail, they conducted a case-control study among patients aged over 50 seen at the Birmingham, AL Department of Veterans Affairs Medical Center. The 550 cases were patients newly diagnosed with macular degeneration between 1997 and 2001, and these were each matched with 10 controls who did not have macular degeneration.
Macular degeneration patients less likely to use statin
The researchers found that those patients with macular degeneration were significantly more likely to have diabetes, high blood pressure, or vascular disease, but there were no differences between them and the comparison group in terms of arterial disease or lipid metabolism disorders.
An overview of the drugs they had been prescribed showed that those with macular degeneration were 50% less likely to have been prescribed statins than those without. Statins had been prescribed for 6.7% of cases compared with 13.6% of controls (odds ratio 0.45, 95% CI 0.32-0.64). This association remained significant irrespective of whether statin use was current or past or whether patients had other medical conditions, including diabetes, lipid metabolism disorders, hypertension, ischemic heart disease, cerebrovascular disease, and arterial disease.
Nonstatin lipid-lowering medications were also less common among cases than controls, but this association was not statistically significant and of lesser magnitude than that observed for statins. "Whether this indicates that the association is limited to statins only or that the association also exists for nonstatin lipid-lowering medications, albeit weaker, will require additional research," the authors say. They add that it cannot be concluded that the association between statin use and a reduction in macular degeneration suggested here represents a cause-and-effect relation and that future research will also be required to address this issue, possibly in the form of a randomized clinical trial.
