Low intravitreal angiopoietin‐2 and VEGF levels in vitrectomized diabetic patients with simvastatin treatment

Abstract

In diabetic patients with DME or PDR, the intravitreal levels of permeability and proangiogenic factors Ang-2 and VEGF were lower in simvastatin-treated than in those without statin medication. Moreover, the levels of MMP-9 and TGF-β1, factors involved in the breakdown of basement membrane and fibroproliferation, were lower in patients with PDR having simvastatin medication. When acetylsalicylic acid was combined with simvastatin treatment, the intraocular levels of Ang-2 and VEGF were significantly lower than in diabetics treated with simvastatin alone. These data provide a novel insight into the potential protective mechanisms underlying simvastatin medication in patients with diabetic retinopathy complications.

Lipid‐lowering medication is associated with decreased risk of diabetic retinopathy and the need for treatment in patients with type 2 diabetes: A real‐world observational analysis of a health claims database

“…Atorvastatin significantly reduced the oxidative stress level in a rat model involving hyperlipidaemia 26 and decreased expression of vascular endothelial growth factor in rats. 29 Fibrates are expected to lower triglyceride and increase HDL cholesterol. 28 Patients who are using statins showed a lower concentration of angiopoietin-2, which is known to increase permeability and to have proangiogenic characteristics, in the vitreous obtained at the time of vitreous surgery.…”

Statin use and vitreoretinal surgery: Findings from a Finnish population‐based cohort study

“…Nonetheless, all of these compounds have failed to demonstrate a significant benefit in clinical VR trials. More recently, statin therapy was found to be beneficial also in VR surgery (Tuuminen et al 2014(Tuuminen et al , 2015. Histologic analyses have revealed decreased inflammatory response and reduced fibrosis in the statin-treated group when compared with control group (Park et al 2016).…”

“…Our main hypothesis was that use of statin medication might reduce the risk of reoperations based on the findings of our previous studies involving different VR pathologies (Tuuminen et al 2014(Tuuminen et al , 2015. Statins are currently widely used in many VR patients, but no populationbased large-scale systematic studies of statin use and outcome of VR surgery have yet been published.…”

Role of lipid-lowering agents in the management of diabetic retinopathy

“…In patients with diabetic retinopathy, statins reduce vascular resistance in the ophthalmic and central retinal arteries[39]. In addition, vitreous concentrations of VEGF, angiopoietin-2, MMP-9 and transforming growth factor β1 are lower in patients with diabetic retinopathy treated with statins[40]. …”