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D. De Castro, O.S. Punjabi, A.G. Bostrom, R.L. Stamper, S.C. Lin; Effect of Statin Drugs and Aspirin on Progression in Glaucoma Suspects . Invest. Ophthalmol. Vis. Sci. 2006;47(13):3399.
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To determine whether the use of oral statin drugs or aspirin affects the rate of progression in primary open–angle glaucoma suspects, as defined by the degree of optic nerve damage measured by the Heidelberg Retinal Tomograph II (HRT).
Data of patients diagnosed as primary open–angle glaucoma suspects who had undergone at least two HRT tests at the Beckman Vision Center at UCSF from January 2001 to September 2005 was recorded. We conducted a retrospective chart review of 170 eyes from 87 patients considered suspect for glaucoma based on a cup–to–disc ratio > 0.5 but without peripheral field defects. These patients all had normal intraocular pressure (IOP) (< 21 mm Hg) throughout the duration of the study. Subjects included glaucoma suspects who took statin drugs or aspirin for greater than 23 months. The control group was composed of glaucoma suspects who never used statins or aspirin, or who used them for less than 23 months. We compared the changes in HRT optic nerve parameters per year in the eyes of patients who took statins or aspirin to those who did not.
The data was analyzed using mixed effects regression. There were statistically significant differences found in the change in the cup–to–disc area ratio per year between the control group (increased by 2.0%) and the statin only group (decreased by 3.4%; p=0.0082), as well as in the change in rim volume per year between the control group (decreased by 0.15%) and the statin only group (increased by 9.4%; p=0.0024). There were additional statistically significant differences found in the slopes of other HRT parameters, including rim–to–disc area ratio (p=0.0309), linear cup–to–disc ratio (p=0.0072), retinal nerve fiber layer (RNFL) cross sectional area (p=0.0080), and mean global RNFL thickness (p=0.0084) when comparing the statin only group to the other subjects, even when adjusting for IOP, central corneal thickness, myopia of –1 D or worse, and the presence of hypertension, diabetes mellitus, and migraines. No such significant differences were found when comparing the aspirin only group to the rest of the study population.
Statin drugs, but not aspirin, are associated with slowed progression of optic nerve damage in glaucoma suspects as measured by HRT parameters. Prospective studies are necessary to further investigate the effect of statins in the development of optic nerve damage in glaucoma suspects.
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