Influence of Statins on the Development and Progression of AMD
In the quest to determine whether statins are associated with the development or progression of age-related macular degeneration (AMD), researchers reviewed a large, national insurance claims database to identify individuals aged 60 years or older who were enrolled for two or more years and had one or more visits to an eye-care provider.
They also reviewed prescription claims for statins within a 24-month look-back period as well as outpatient lipid laboratory values. They used Cox regression analysis to determine whether statin use was associated with the development of nonexudative or exudative AMD or progression from nonexudative to exudative AMD.
Of the 107,007 beneficiaries eligible for the nonexudative AMD analysis, the researchers noted that 4,647 incident cases of nonexudative AMD occurred. They also found 792 incident cases of nonexudative AMD among the 113,111 beneficiaries eligible for the exudative AMD analysis. They reported that of the 10,743 beneficiaries with known nonexudative AMD eligible for the progression model, 404 progressed to exudative AMD during their time in the plan. Following multivariable analysis, statin use was not associated with the development of nonexudative AMD (p>0.05). However, statin use of more than 12 months was associated with an increased hazard for developing exudative AMD (p<0.005). Furthermore, among those taking statins, only enrollees with the highest lipid levels had an increased hazard of developing exudative AMD (p<0.05).
In conclusion, in those with elevated lipid levels, more than one year of statin use was associated with an increased hazard for exudative AMD. Lipid status influences the relationship between statins and the risk of AMD. Because of a number of limitations in study design, these observations warrant further study and should not be the rationale for any changes in the use of statins to treat dyslipidemias.