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C. A. Cukras, E. Agron, J. P. SanGiovanni, T. Clemons, F. L. Ferris, III, E. Y. Chew; The Use of Statins and the Development of AMD in AREDS. Invest. Ophthalmol. Vis. Sci. 2008;49(13):3772.
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To evaluate the association of statin use with incident advanced age-related macular degeneration (AMD) in patients enrolled in the Age-Related Eye Disease Study (AREDS).
1266 AREDS participants at intermediate to high risk of AMD (AREDS Category 3 and 4) were analyzed in this clinic-based prospective cohort. The primary outcome is development of neovascular AMD (NV) and central geographic atrophy (CGA) assessed from gradings of stereoscopic color fundus photographs taken at baseline and at annual visits beginning at year 2. Secondary outcomes were the development or progression of AMD along the AREDS Simple Scale for classification of AMD severity. Covariates considered included those previously identified in AREDS reports numbers 3 and 19. History of statin use was collected at the final study visit. Statistical analyses included logistic regression models.
Participants were followed for a median of 11 years with 481 patients developing advanced AMD (323 NV AMD and 233 CGA AMD). In multivariable analysis, statin use was statistically significantly associated with the development of advanced AMD (odds ratio (OR): 1.43; 95% confidence interval (CI): 1.12-1.83). In analyses for types of advanced AMD, statin use was associated only with the development of NV AMD (odds ratio: 1.76; 95% CI: 1.34-2.30) and not the development of CGA. Other statistically significant covariates were: age, race, smoking, hypertension, AMD severity and antioxidant/zinc treatment.
In AREDS, statin use was associated with the risk of developing neovascular AMD. Previous studies have found inconsistent associations with cardiovascular risk factors, such as elevated cholesterol. Because statin use may be confounded with systemic conditions, such as elevated cholesterol, a causal relationship should not be presumed from these observational data.
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