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Hubert Pham, Arthi Venkat, Solomon Makgoeng, Alexander Melamud; Effect of Statins on Visual Outcomes in Primary Rhegmatogenous Retinal Detachments. Invest. Ophthalmol. Vis. Sci. 2013;54(15):3784.
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Statins have been theorized to aid in neurologic recovery after a stroke or traumatic brain injury through anti-inflammatory and neuroprotective mechanisms. By viewing rhegmatogenous retinal detachment (RRD) as a form of ischemic insult similar to a stroke with the addition of mechanical shearing forces similar to a traumatic brain injury, it can be hypothesized that statins may have similar neuroprotective effects and may result in improved visual acuity after RRD repair. This study looks to evaluate whether visual and anatomic outcomes following retinal detachment are improved in individuals on long-term statin therapy following surgical repair of primary RRDs.
This is a retrospective, consecutive, interventional case series. All eyes underwent repair of rhegmatogenous retinal detachment (RRD) with either a standard 3-port pars plana vitrectomy (PPV) or a scleral buckling procedure (SB). Eyes with previous retinal surgery, giant retinal tear, grade C or higher proliferative vitreoretinopathy, or any other ocular comorbidity that might affect visual acuity were excluded. The main outcome measure studied was final best-corrected visual acuity (BCVA) as a function of ongoing statin use at the time of surgery. Secondary outcome measures included change in pre- to post-operative BCVA and rates of redetachment.
160 eyes of 159 patients met inclusion criteria, with a mean follow-up length of 20.1 months (range 1-108) and with 45 patients using statins (28%). In those using statins, pre-operative logMAR BCVA 0.756 (20/114) improved to 0.196 (20/31); those not taking statins improved from 0.518 (20/66) to 0.231 (20/34) post-operatively. Overall, 77.5% of patients obtained 20/40 or better final BCVA (82% statins vs. 73% non-statins). While the data tended to suggest overall better visual outcomes and an increased improvement in BCVA from pre- to post-operatively in those taking statins, there was no statistically significant correlation found when controlling for confounders, such as pre- and post-op lens status, age and type of procedure performed (p>0.10). Moreover, there was no difference in rates of redetachment during the follow-up period (statins 4.4%, non-statins 3.5%; p > 0.10).
Statins do not correlate with improved visual or anatomical outcomes after repair of primary RRD with either SB or PPV.
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