Can statins prevent age-related macular degeneration?

One of my patients came into my clinic last week and asked me if statins can prevent age-related macular degeneration. Many of my patients already take statins for their heart disease and atherosclerosis and are often keen to know if there are additional benefits for their eyes.

I thought I would share my thoughts on this with you. Especially as there has been a recent clinical trial in the news that has reported some interesting new findings on the subject.

To date, there have not been large clinical studies that have shown definitive beneficial effects of taking statins to treat or prevent age-related macular degeneration.

Most of the clinical studies that have shown some benefit of statins in the prevention of AMD have been conducted by retrospective analysis. This can be inaccurate compared to carefully designed studies. Those are prospective and conducted specifically to answer the research question. These studies also include small numbers of patients where meaningful results can be quite hard to find.

One recent study from Harvard Medical School has had some interesting results. Firstly it is important to note that the trial was small and consisted of just 23 patients. The researchers showed, that giving patients a double daily dose of statins, specifically Lipitor (atorvastatin), cleared away the fatty deposits. This collect in the ageing retina known as drusen in 10 of those 23 patients. Some of those patients also reported clearer vision. The average duration of statin treatment was 1 to 1.5 years before an effect was seen. The authors also reported that the patients may have been protected from developing wet age-related macular degeneration. None of them progressed to developing wet age-related macular degeneration during the study period.

Why would a statin medicine, designed to lower cholesterol in patients with heart disease and atherosclerosis, have any effect on AMD?

Recent studies have shown similarities between some of the disease mechanisms involved in dry AMD and atherosclerosis. That is why scientists have tried the medicine in macular degeneration patients.

This is a very interesting study but I do emphasise that the trial is too small to draw any meaningful conclusions at the moment. What it does show is that with larger clinical trials and a greater number of trial patients, we may have a potential way of preventing or even curing dry age-related macular degeneration. Firstly, we have to ensure the drug dosing is safe with minimal and acceptable side effects. Secondly, we have to prove that the beneficial effect is due to the drug effect, rather than any other contributing factors. Those can be smoking or diet, which can often be very difficult to do. It would be useful to do longer term studies to see if this effect is sustained with or without statin treatment.

Statins have been proven to significantly benefit patients with heart disease and atherosclerosis. You should continue to take them if prescribed by your doctor.