While the treatment of wet age-related macular degeneration (AMD) has been a success story over the last decade, dry AMD treatment has stalled and little progress has been made in preventing AMD from developing in the first place. Against this background, a team of researchers from the University of California, San Francisco, and Stanford University examined the US National Health and Nutrition Examination Survey (NHANES) dataset to determine whether statin use exhibited a protective effect against AMD (1).
Why statins? Classically, they are used to reduce serum lipoprotein levels, treating dyslipidaemias like atherosclerosis. Statins have shown great benefit in reducing cardiovascular mortality and morbidity, and have prevented (or delayed) millions of heart attacks since their introduction – cardiologists half-joke that they should be offered as a condiment at fast-food restaurants (2).
Many of the risk factors that are associated with cardiovascular disease are also risk factors for AMD, including cigarette smoking, elevated serum cholesterol and hypertension. So the authors set out to determine if lipid-lowering medications exert a preventive effect in AMD development. To find out, they examined 5,604 patients aged over forty years from the NHANES dataset for the presence of AMD, statin use, comorbidities and health-related behaviors like cigarette smoking. The mean age of patients without a history of AMD was 55 years, and with AMD was 68 years. This stratification by age provided an important insight: after adjustment for confounding factors, individuals aged 68 years or more who took statins were significantly less likely to have AMD than those who did not (odds ratio: 0.64, p=0.002). In those aged between 40 and 67 years, no significant association was found between the prevalence of AMD and statin consumption. The authors concluded that “statin intake […] significantly lowers the odds for AMD in individuals 68 years of age or older”. As dry AMD was the more common form of the disease in the study, perhaps the authors’ findings may open a new therapeutic avenue for the treatment of dry AMD?
References
- D.T.Q. Barbosa et al., “Age-related macular degeneration and protective effect of HMG Co-A reductase inhibitors (statins): results from the National Health and Nutrition Examination Survey 2005–2008”, Eye (2014). Epub ahead of print, doi: 10.1038/eye.2014.8. E.A. Ferenczi et al., “Can a Statin Neutralize the Cardiovascular Risk of Unhealthy Dietary Choices?”, Am. J. Cardiol, 106, 4, 587–592 (2010). doi: 10.1016/j.amjcard.2010.03.077.
