Statins and the progression of age-related macular degeneration in the United States

Abstract

Purpose To study the effect of statin exposure on the progression from non-exudative to exudative age-related macular degeneration (AMD). Methods Retrospective cohort study of commercially insured patients diagnosed with non-exudative AMD (n = 231,888) from 2007 to 2015. Time-to-event analysis of the association between exposure to lipid-lowering medications and time from non-exudative AMD to exudative AMD diagnosis was conducted. Outcome measures included progression to exudative AMD, indicated by diagnosis codes for exudative AMD or procedural codes for intravitreal injections. Results In the year before and after first AMD diagnosis, 11,330 patients were continuously prescribed lipid-lowering medications and 31,627 patients did not take any lipid-lowering medication. Of those taking statins, 21 (1.6%) patients were on very-high-dose lipophilic statins, 644 (47.6%) on high-dose lipophilic statins, and 689 (50.9%) on low-dose lipophilic statins. We found no statistically significant relationship between exposure to low (HR 0.89, 95% CI 0.83 to 1.38) or high-dose lipophilic statins (HR 1.12, 95% CI 0.86 to 1.45) and progression to exudative AMD. No patients taking very-high-dose lipophilic statins converted from non-exudative to exudative AMD, though this difference was not statistically significant due to the subgroup size (p = .23, log-rank test). Conclusions No statistically significant relationship was found between statin exposure and risk of AMD progression. Interestingly, no patients taking very-high-dose lipophilic statins progressed to exudative AMD, a finding that warrants further exploration.

The Relationship between Statin and Risk of Age-Related Macular Degeneration: A Systematic Review and Meta-Analysis

“…A total of 2063195 participants and 313702 (15.20%) AMD patients were included in the reviewed articles. Among the studies, 11 used a cohort design with a sample size of 1462588 participants and 255970 (17.50%) AMD patients [ 20 – 30 ], eight had a case-control design with a sample size of 588648 participants and 54776 (9.30%) AMD patients [ 6 , 31 – 37 ], and three had a cross-sectional design with a sample size of 11959 participants and 2956 (24.71%) AMD patients [ 38 – 40 ] ( Table 1 ).…”

“…The articles included in this systematic review and meta-analysis were published between 2003 and 2021. The studies had been conducted in diverse geographical regions, with thirteen conducted in North America [ 6 , 20 , 21 , 23 , 26 , 28 – 30 , 33 , 34 , 36 , 39 , 40 ], four in Europe [ 24 , 27 , 31 , 32 ], four in Asia [ 25 , 35 , 37 , 38 ], and one in Australia [ 22 ]. The mean age of the participants in the studies was 67.91 years ( Table 1 ).…”

“…Therefore, it can be assumed that high cholesterol and AMD development are related [ 41 , 42 ]. Therefore, taking cholesterol-lowering medications, such as statins, may be able to prevent or delay the onset and progression of AMD [ 29 , 30 , 40 ]. However, the results and findings of studies in this field are not conclusive and transparent [ 28 – 30 , 39 , 40 ].…”

“…Therefore, taking cholesterol-lowering medications, such as statins, may be able to prevent or delay the onset and progression of AMD [ 29 , 30 , 40 ]. However, the results and findings of studies in this field are not conclusive and transparent [ 28 – 30 , 39 , 40 ]. Consequently, given the importance of the issue and the potential inhibitory effects of statins on the onset and development of AMD, it is important to continuously review and evaluate emerging findings related to this question.…”

Statin Use in Relation to Intraocular Pressure, Glaucoma, and Ocular Coherence Tomography Parameters in the UK Biobank

“…Given the widespread use of statins, there is intense interest in their impact on non-cardiovascular outcomes, including eye diseases. 6 , 7 …”