Aim: Statins have been established in the market not only due to their ability to lower plasma cholesterol levels but also due to their pleiotropic effects. In the literature, there is a controversy regarding the role of statins in ophthalmology. We aimed to systematically address the possible effect of statin therapy on ocular diseases and to identify if there is a beneficial relationship. Methods: We searched PubMed and Cochrane Library databases up to 31 December 2022 for studies evaluating the effect of statins on ocular diseases. We included all relevant Randomized Control Trials (RCTs) that have been conducted in the adult population. PROSPERO registration number: CRD42022364328. Results: Nineteen RCTs were finally considered eligible for this systematic review, with a total of 28,940 participants. Ten studies investigated the role of simvastatin, suggesting a lack of cataractogenic effect and a possible protective role in cataract formation, retinal vascular diseases, and especially diabetic retinopathy, age-related macular disease progression, and non-infectious uveitis. Four studies investigated lovastatin, showing no cataractogenic effect. Three studies examined atorvastatin, revealing conflicting results regarding diabetic retinopathy. Two studies examined rosuvastatin, indicating a possibly harmful effect on lenses and a significant protective effect on retinal microvasculature. Conclusions: Based on our findings, we believe that statins have no cataractogenic effect. There are indications that statins may have a protective role against cataract formation, AMD, diabetic retinopathy progression, and non-infectious uveitis. However, our results were insufficient for any robust conclusion. Future RCTs, with large sample sizes, on the current topic are therefore recommended to provide more solid evidence.

Background: Ocular adnexal lymphomas (OAL) are rare tumors arising in the eyelid, conjunctiva, lacrimal apparatus or orbit. The most frequent subtype is extranodal marginal zone lymphoma of mucosal associated lymphoid tissue (MALT). Bilateral disease, primary site, histology and stage at diagnosis affect prognosis.Methods: Retrospective study characterizing the epidemiology and outcomes of OAL diagnosed patients (pts) in our center from 2005 to 2021. Overall (OS) and progression free survival (PFS) were calculated by the Kaplan Meier method.Results: From 2005 to 2021 45 pts with OAL were included. Median age at diagnosis was 67 yo (8-97) and female: male ratio 1,65. Only 2 pts had bilateral disease and the most common sites were orbit (37,8%) and eyelid (33,3%). All pts had B-cell lymphomas and most presented with MALT (71,1%) and stage IE (73,3%). A complete response to treatment (CR) occurred in 71,1% pts and a 1 st recurrence in 28,9% (after a median of 24,6 months, 0-127,4). Median follow-up was 50 months (mo) (1,7-173,9), median PFS was 29,5 mo (0-127,4) and median OS was 41,5 mo (1,6). Gender (p ¼ 0,151), lymphoma subtype (p ¼0,588), primary site (p ¼ 0,651), stage (p ¼ 0,116), combined versus non-combined treatment (p ¼ 0,792) and CR versus non-CR (p ¼ 0.203) did not influence PFS. Conversely, indolent subtypes (p ¼ 0,005), stage IE (p ¼ 0,000) and CR (p ¼ 0,020) positively influenced OS but gender (p ¼ 0,278), primary site (p ¼ 0,626) and combined versus non-combined treatment (p ¼ 0,619) did not.Conclusions: OAL are more frequent in the 6 th and 7 th decades and in female pts. Orbit and eyelid are the most common primary sites. MALT is the most common subtype and most pts present with localized disease, with favorable outcomes.Legal entity responsible for the study: The authors.