Abstract
Purpose :
Dyslipidemia has been associated with diabetes mellitus (DM), diabetic retinopathy (DR), and worsening of disease status. Statin and fibrate class medications have also been associated with a reduction in DR disease progression to advanced proliferative DR (PDR). However, real world data on the ability of these drugs to prevent progression is lacking. The purpose of this study is to evaluate if cholesterol-lowering medications have a potential protective effect against the prevalence of DR and advanced DR complications.
Methods :
TriNetX, a live cross-sectional database comprised of over 79 million Americans, was utilized for this study. Data was collected using ICD codes and was obtained between June and August 2022. Prevalence and prevalence odds ratios were calculated.
Results :
7,908,291 Americans were defined as having dyslipidemia when this study took place, amounting to a prevalence of 26.7% in the general population greater than 60 years old, 50% in the DM population, and 65% in the DR population. Patients taking stronger cholesterol lowering medications including pitavastatin (statin class) (OR 0.64, 95% CI 0.49, 0.84), fenofibrate (fibrate class) (OR 0.83, CI 0.79, 0.87), or evolocumab (PCSK9 inhibitor class) (OR 0.80, CI 0.68, 0.95) were found to have lower prevalence odds ratios of PDR compared to having nonproliferative diabetic retinopathy (NPDR). Patients taking any cholesterol medication were less likely to experience vitreous hemorrhage (VH). Patients taking fibrates had a decreased likelihood of also experiencing a diagnosis of neovascular glaucoma (NVG). Additionally, Hispanic or Latino females and white females had higher rates of dyslipidemia compared to white males, but lower odds ratios of being treated with a cholesterol-lowering medication, potentially indicating a treatment discrepancy.
Conclusions :
The present study highlights a positive association between DR and dyslipidemia, as well as medications that may have protective effects with respect to DR status and worsening events. Further clinical trials are necessary to better understand the true therapeutic effect of these medications and potential discrepancies in prescribing practices.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.