COMMENTARY

Statins and the Hazard of Developing Age-Related Macular Degeneration

Yousef J. Cruz-Inigo; Sophie J. Bakri, MD

Disclosures

September 30, 2013

Role of Statins in the Development and Progression of Age-related Macular Degeneration

VanderBeek BL, Zacks DN, Talwar N, Nan B, Stein JD
Retina. 2013;33:414-422

Study Summary

VanderBeek and colleagues studied the association of statin use with the hazard of developing nonexudative and exudative age-related macular degeneration (AMD), as well as the progression from nonexudative to exudative AMD.

The i3 InVisionTM Data Mart (BioSpace; Ann Arbor, Michigan) database was used to access medical records from a large managed care network in the United States. Only persons aged 60 years or older who were in the database for more than 2 consecutive years and had 1 or more visits to either an ophthalmologist or an optometrist from January 1, 2001, through December 31, 2007, were included. A total of 486,124 beneficiaries met the study inclusion criteria.

Statin use was determined by pharmacy records. Laboratory lipid values, including high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and triglyceride levels, were reviewed and categorized according to the American Heart Association system.

Cox regression analysis showed that statin use for more than 1 year was associated with an increased hazard of developing exudative AMD (P < .005). After multivariable analysis, statin use was not associated with the development of nonexudative AMD (P > .05). In addition, the groups with the highest HDL cholesterol (≥ 60 mg/dL), LDL cholesterol (≥ 160 mg/dL), and triglyceride (≥ 200 mg/dL) levels who were prescribed statins for more than 1 year had significantly higher hazards of developing or progressing to exudative AMD compared with those having similar lipid levels and using statins for 6 months or less (P < .05).

Viewpoint

The potential side effects of long-term statin use in patients with dyslipidemia are concerning. Healthcare providers should interpret these results with caution because the study was not designed to determine causation. Furthermore, important confounding variables, such as tobacco use and vitamin intake, were not included, and patient adherence was not addressed.

Despite its limitations, this study highlights the importance of conducting large long-term prospective studies to determine whether statin intake in young and elderly patients with dyslipidemia represents a threat to their central vision.

Abstract

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