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Statins may offer benefit in AMD treatment

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A well-known group of cholesterol-lowering drugs may decrease the rate of choroidal neovascularization in patients with age-related macular degeneration, a large study found. Patients on aspirin therapy may reap similar benefits, the researchers noted.

Hilary L. Wilson and colleagues at the University of California San Francisco investigated the relationships between progression of AMD and the use of statins or aspirin. They found that subjects with CNV were significantly less likely to use statins or aspirin than subjects with dry AMD.

The researchers included in their study all patients with AMD 60 years of age and older who were seen at one Veterans Affairs hospital over a period of more than a decade. The main outcome measure was angiographically evident CNV. For those with CNV, age of onset was recorded. AMD disease status and time of onset was compared between patients treated or not treated with statins for at least 6 months.

Of the total group of 326 patients, 104 had CNV, 204 had dry AMD and 18 had geographic atrophy.

Of the patients with CNV, 21 (20%) used statins, compared to 77 (38%) of patients with dry AMD without geographic atrophy and six (33%) of the control group with geographic atrophy.

Aspirin use was also significantly associated with decreased rates of CNV. Of those patients with CNV, 62 (60%) used aspirin, compared to 154 (75%) of patients with dry AMD without geographic atrophy and 12 (67%) with geographic atrophy.

“Statin use may be associated with reduced rates of CNV among AMD patients due to their effects on serum lipid profiles, because some studies have found an association between serum cholesterol and CNV, and cholesterol accumulation has been reported in Bruch membrane and drusen of older eyes,” the authors said in the April issue of the American Journal of Ophthalmology.

The authors noted that the association between the reduced risk of CNV among patients with AMD and the use of both aspirin and statins could be due either to the cardioprotective or the anti-inflammatory properties of the medications. Further, a common disease mechanism may be responsible for both cardiovascular disease and advanced AMD, the authors speculated. Further study is warranted based on this study’s conclusions, the authors said.