Abstract
Abstract: :
Purpose: It has been hypothesized that statins may reduce the risk of age–related macular degeneration (AMD) by lipid–lowering, anti–oxidant and anti–inflammatory actions. We evaluated the association between statin use and the risk of neovascular AMD in a series of extremely discordant sibpairs. Methods: As part of an ongoing retrospective matched case–control study to determine genetic and epidemiologic factors that are associated with neovascular AMD, epidemiologic data including medication use, history of smoking, hypertension, cardiovascular disease (angina, myocardial infarction, stroke) and hyperlipidemia were obtained on extremely discordant sibpairs (index case with neovascular AMD and a sibling past the age of diagnosis of the index patient with normal maculae or maculae with 0–5 small drusen). These data were obtained by administration of a standardized questionnaire to each subject, and were examined up to a referent age (the age of AMD diagnosis of the affected sibling or the youngest age of diagnosis in sibships with more than one affected sibling (n=4)). Disease status was confirmed by fundus photography by two investigators; a home retinal examination was performed by one of the investigators for home–bound subjects (n=4). Conditional logistic regression (StataCorp) was used to determine if statins play a protective role in the development of neovascular AMD. Results: Of 73 sibpairs included in this analysis, 16 (22%) were discordant with regard to statin use. Seventeen (14%) subjects were taking statins regularly, prior to the referent age. In a multivariate model, which controlled for the effect of smoking, an association between statin use and neovascular AMD was not demonstrated (OR: .65, 95% CI: .17–2.5, p=.53). Similarly, duration of statin use was not associated with reduced risk of disease (OR: .88, 95% CI .72–1.1, p=.21). Conclusions: In this small set of sibpairs, a protective effect for statins was not observed. Additional sibpairs will be examined and included in future analyses to clarify the role of statins in the development of neovascular AMD.
Keywords: age–related macular degeneration • choroid: neovascularization • clinical (human) or epidemiologic studies: risk factor assessment