Drusen Volume Change in Patients with Age-related Macular Degeneration Receiving High-Dose Atorvastatin

Abstract

Purpose : To assess the change in drusen volume over time in patients with age-related macular degeneration (AMD) treated with high-dose atorvastatin.

Methods : Our observational, cross-sectional study evaluated patients with intermediate AMD treated with oral atorvastatin 80 mg daily. Vision functional tests, including visual acuity and dark adaptation, and multi-modal imaging, including optical coherence tomography and fundus photography, were gathered. We evaluated average changes in drusen volume at baseline and at one year in 17 eyes of 10 patients (73.24±7.06 years; 6 female) using semi-automated segmentation of 97 B-scans on spectral-domain Optical Coherence Tomography (SD-OCT, SPECTRALIS® Heidelberg) in all Early Treatment Diabetic Retinopathy Study (ETDRS) subfields. A paired t-test was performed (p<0.05; CI 95%). The presence of intraretinal hyperreflective foci (IHRF), subretinal drusenoid deposits (SDD), incomplete retinal pigment epithelium (RPE) and Outer Retinal Atrophy (iRORA), complete RPE and Outer Retinal Atrophy (cRORA), drusenoid pigment epithelial detachments (PED), and exudate were recorded. Univariate linear regressions were performed (p<0.05; CI 95%) between changes in drusen volume and OCT biomarkers, age, sex, fellow eye status, and time at follow-up.

Results : Average follow-up time was 12.6 ± 2.09 months. At follow-up, average drusen volume was decreased from baseline in all subfields and reached significance in the outer nasal (ON, p= 0.023), inner temporal (IT, p= 0.030), outer superior (OS, p= 0.032), central (C, p= 0.033), and inner nasal (IN, p= 0.037) subfields (Figure 1). Univariate analysis revealed significantly reduced drusen volumes in the inner inferior (II, β= -0.038; p= 0.018), outer inferior (OI, β= -0.035; p= 0.041), and inner temporal (IT, β= -0.023; p= 0.009) subfields in eyes with baseline iRORA (n=5) and within the inner temporal (β= -0.21; p= 0.007) subfield in eyes with IHRF (n=9). Three eyes developed iRORA, and no eyes developed cRORA or neovascular AMD.

Conclusions : Our results in a small study showed that treatment with a high-dose statin significantly reduced drusen volume at 1 year among eyes with AMD. Statins may play a role in the clinical management of AMD, including preventing progression to advanced AMD

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

 

Figure 1. Average Drusen Volume at baseline and 1 year in 10 patients on High Dose Statin. Significant p-values (p<0.05) are shown.