Sunday 24 January 2010, 12:44PM
PEARLS No. 212, November 2009, written by Brian R
McAvoy
Clinical question
How effective are statins in delaying the onset and/or progression
of age-related macular degeneration (AMD)?
Bottom line
In the one completed trial, the analyses of 30 participants showed
no statistically significant difference between the simvastatin and
the placebo arm in visual acuity at 3 months of treatment or 45
days after the completion of treatment. The lens and retina status
were unchanged during and after the treatment period for both
groups. In the ongoing trial, the preliminary analyses of 42
participants who completed 12 months' follow-up did not show a
statistically significant difference between the simvastatin and
the placebo arm in visual acuity, drusen score or visual function
(effect estimates and confidence intervals were not available).
Caveat
There were only 2 small studies, one of which is still ongoing.
Context
AMD is a progressive late onset disorder of the macula that
affects central vision. Although AMD is the leading cause of
blindness in people over 65 years in industrialised countries,1 its
pathogenesis is not clearly understood. Recent epidemiologic,
genetic and pathological evidence has shown AMD shares a number of
risk factors with atherosclerosis, leading to the hypothesis that
statins may exert protective effects in AMD.
Cochrane Systematic Review
Gehlbach P et al. Statins for age-related macular degeneration.
Cochrane Reviews 2009, Issue 3. Article No. CD006927. DOI:
10.1002/14651858.CD006927.pub2. This review contains 2 studies
involving 72 participants.
Further reference
1. Congdon NG et al. JAMA 2003;290:2057-60.