April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
The Association of Statin Use with Cataract Progression Using Propensity Matching in the Age-Related Eye Disease Study 2 (AREDS2)
Author Affiliations & Notes
  • Shaza Al-Holou
    National Eye Institute, National Institutes of Health, Bethesda, MD
    Medical School, University of Michigan, Ann Arbor, MI
  • William R Tucker
    National Eye Institute, National Institutes of Health, Bethesda, MD
  • Elvira Agron
    National Eye Institute, National Institutes of Health, Bethesda, MD
  • Traci E Clemons
    EMMES Corporation, Rockville, MD
  • Emily Y Chew
    National Eye Institute, National Institutes of Health, Bethesda, MD
  • Footnotes
    Commercial Relationships Shaza Al-Holou, None; William Tucker, None; Elvira Agron, None; Traci Clemons, None; Emily Chew, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 1675. doi:
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      Shaza Al-Holou, William R Tucker, Elvira Agron, Traci E Clemons, Emily Y Chew, ; The Association of Statin Use with Cataract Progression Using Propensity Matching in the Age-Related Eye Disease Study 2 (AREDS2). Invest. Ophthalmol. Vis. Sci. 2014;55(13):1675.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract
 
Purpose
 

To examine the potential association of statin use with the progression of cataract.

 
Methods
 

AREDS2 was a 5 year prospective randomized clinical trial of nutritional supplements for the treatment of age-related macular degeneration and lens opacities. Masked graders at the reading center evaluated annual red reflex fundus photographs for incident pseudophakia/aphakia, cortical and posterior subcapsular (PSC) lens opacities. Nuclear cataract status, evaluated clinically at each study visit, demonstrated high variability, thus these data were not used. History of cataract surgery was obtained during the 6 month telephone calls. Study participants self-reported concurrent use of statins. Covariates potentially associated with the use of statins were analyzed in a logistic regression to estimate propensity scores. Statin and non-statin users were paired based on their propensity scores using Greedy Matching Techniques in order to balance the covariates. Cox regression was performed to estimate the effect of statin use on the progression of cataract in either eye.

 
Results
 

Of the 4203 AREDS2 participants (age range 50-85 years), 2771 were phakic at baseline with available data for analysis. Covariates in logistic regression included age, sex, smoking status, aspirin use, diabetes, hypertension, history of heart disease including angina, and history of stroke. Matching statin users and non-users by their propensity score resulted in 904 pairs. Statin users had an increased risk of incident cataract surgery [hazard ratio (HR), 3.28; 95% confidence interval (CI), 1.74-6.18]. This persisted after adjusting for age and sex [HR 2.15, 95%; CI 1.08-4.32]. Further subgroup Cox regression analysis based on sex revealed female but not male participants had a statistically significantly increased risk of both incident cataract surgery and progression of cortical or PSC lens opacity. The results of Cox regression are shown in Table 1.

 
Conclusions
 

Statin use was associated with an increased risk of: 1) incident cataract surgery, a likely surrogate for nuclear cataract, and of 2) cortical and 3) PSC lens opacity progression. The results showed a consistent statistically significant association in women for cataract surgery and the 2 cataract types.

 
 
Table 1. Cox Regression Results of Association of Statin Use and Cataract Progression and Surgery using Propensity Score
 
Table 1. Cox Regression Results of Association of Statin Use and Cataract Progression and Surgery using Propensity Score
 
Keywords: 445 cataract • 583 lipids  
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