Atorvastatin in clinically-significant macular edema in diabetics with a normal lipid profile

Narang, Subina; Sood, Sandeep; Kaur, Baljit; Singh, Ramandeep; Mallik, Arun; Kaur, Jaskirat

doi:10.3126/nepjoph.v4i1.5846

Cited by 17 publications

(18 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A review of clinical trials 7 concluded the improvement of hard exudates with pravastatin, Ozkiris et al 8 conducted a double-blind placebo-controlled trial and concluded that atorvastatin decreased the mean systolic blood pressure in the ophthalmic and central retinal arteries and hence prevents retinopathy progression, a case-control study from USA 9 included 6,441 patients and followed for five years found no association between statins and diabetic retinopathy, a case-series published in Greece 10 observed the improvement of hard exudated and macular oedema. A study assessed the effects of atorvastatin on diabetic retinopathy found no difference between the drug and the placebo arms 11 Nielsen et al 12 in their retrospective study found that statins could prevent retinopathy even before the development of diabetes, another retrospective study from South Korea 13 showed that statins decreased macular oedema and retinopathy. An observational analysis from Japan 14 included 69,070 patients followed for three years found that statins decreased diabetic retinopathy, and a review conducted on statins effect on various eye disorders 15 concluded that statins decreased macular oedema and progression of diabetic retinopathy.…”

Section: Discussionmentioning

confidence: 99%

The relationship between statins and diabetic retinopathy: A review of literature

Alali¹,

ALBalawi²,

Mirghani³

2020

amj

View full text Add to dashboard Cite

Background Treatment with statins is a robust strategy in reducing cardiovascular complications among patients with diabetes mellitus and chronic kidney disease. There is an increasing awareness regarding the association of statins with diabetic retinopathy. Aims The current review aimed to assess the relationship of statins therapy to diabetic retinopathy. Methods The literature in PubMed and Google Scholar was searched for relevant articles from the first available article up to present using the terms statins, simvastatin, atorvastatin, pravastatin, and diabetic retinopathy. Among the 169 articles retrieved, 26 full-texts were assessed for eligibility and only sixteen studies (four from the USA, another four from Europe, six from Asia, and one from Australia and Brazil each) met the inclusion criteria for the systematic review. The author name, year of publication, country, type of study, number of patients, and the duration of the study were reported. Results The studies reviewed showed that statins reduce the development of diabetic retinopathy, retard the progression of hard exudates and micro-aneurisms, reduce retinopathy and macular oedema. Conclusion Statins prevent and reduce the progression of diabetic retinopathy and macular oedema.

show abstract

Section: Discussionmentioning

confidence: 99%

The relationship between statins and diabetic retinopathy: A review of literature

Alali¹,

ALBalawi²,

Mirghani³

2020

amj

View full text Add to dashboard Cite

show abstract

“…OCT and hard exudate grading was not done in that study as in our study. 16 Michael Cusick et al showed histopathological evidence of regression of hard exudates and macular edema after reduction of elevated serum lipid levels in dyslipidemic patients. Now-a-days trends are shifting towards use of lipid lowering drugs as primary preventive measure for coronary artery disease in type II diabetics with normal lipid profile.…”

Section: Resultsmentioning

confidence: 99%

Effect of atorvastatin on hard exudates in type 2 diabetic patients with normal lipid profile

2020

IJCEO

View full text Add to dashboard Cite

Purpose: To evaluate the effect of Atorvastatin on hard exudates in diabetic retinopathy in type 2 diabetic patients with normal lipid profile. Materials and Methods: Prospective study of 50 patients with clinically significant macular edema involving centre was done over 2 years . We excluded patients with type 1 diabetes mellitus, patients with nephropathy/ heart disease, dyslipidemic patients, patients with laser treatment within 3 months of enrollment, patients with proliferative diabetic retinopathy requiring laser treatment. Detailed history was taken and thorough examination was done with +90 D lens for size and extent of clinically significant macular edema and grading of hard exudates. OCT was done for maximum retinal thickness. The outcome measures were visual acuity, change in grade of hard exudates and maximum retinal thickness. Change in maximum retinal thickness by 30% was considered as significant reduction of macular edema. Patient had minimum follow up of 6 months. Results: Of 50 patients 34 were male and 16 female. Mean follow up period was 10.5±4.0 months. Baseline mean visual acuity was 0.73±0.4 log MAR and baseline mean MRT was 360.03± 30.94 µ. Patients with grade 3 hard exudates were 6, with grade 4 hard exudates were 28 and with grade 5 hard exudates were 16 at baseline. Final mean visual acuity was 0.76±0.4 log MAR. Mean MRT at final visit was 284.6± 48.3 µ. 34 patients (68%) showed improvement by one grade and 2 patients showed improvement by two grade. The grade of hard exudates remained unchanged in 12 patients (24%) and deteriorated in 2 patients. Conclusion: Atorvastatin leads to significant improvement in grade of hard exudates in clinically significant macular edema and decrease in maximum retinal thickness on OCT. However visual acuity status was not significant over short term follow up.

show abstract

“…Similarly, treatment with atorvastatin resulted in a 66% reduction in hard exudates and leakage on fluorescein angiography among eyes with DMO and dyslipidaemia [66]. However, it was not found to be beneficial in DR in 30 diabetic subjects with normal serum lipid levels [67]. The combination of atorvastatin and fibrates demonstrated a significant reduction in macular oedema in 47 diabetic patients with non-proliferative DR [68], as well as reducing the rate of recurrent vitreous haemorrhage in eyes with PDR [69].…”

Section: The Blue Mountains Eyementioning

confidence: 99%

“…Corticosteroids represent the mainstay of the treatment. However, steroids are not ideal for long-term therapy because they are associated with a wide array of side effects, particularly increasing total serum cholesterol levels and induction of diabetes and hypertension, thus Narang et al [67] Randomised control trial 30 patients 6 months Atorvastatin No relation between statin use and reduction in hard exudates, macular oedema or visual acuity in subjects with normal serum lipid levels.…”

Section: Uveitismentioning

confidence: 99%

‘Statins in retinal disease’

Al-Janabi

Lightman

Tomkins-Netzer

2018

Eye

View full text Add to dashboard Cite

Statins are known for their blood cholesterol-lowering effect and are widely used in patients with cardiovascular and metabolic diseases. Research over the past three decades shows that statins have diverse effects on different pathophysiological pathways involved in angiogenesis, inflammation, apoptosis, and anti-oxidation, leading to new therapeutic options. Recently, statins have attracted considerable attention for their immunomodulatory effect. Since immune reactivity has been implicated in a number of retinal diseases, such as uveitis, age-related macular degeneration (AMD) and diabetic retinopathy, there is now a growing body of evidence supporting the beneficial effects of statins in these retinopathies. This review evaluates the relationship between statins and the pathophysiological basis of these diseases, focusing on their potential role in treatment. A PubMed database search and literature review was conducted. Among AMD patients, there is inconsistent evidence regarding protection against development of early AMD or delaying disease progression; though they have been found to reduce the risk of developing choroidal neovascular membranes (CNV). In patients with retinal vein occlusion, there was no evidence to support a therapeutic benefit or a protective role with statins. In patients with diabetic retinopathy, statins demonstrate a reduction in disease progression and improved resolution of diabetic macular oedema (DMO). Among patients with uveitis, statins have a protective effect by reducing the likelihood of uveitis development.

show abstract

Atorvastatin in clinically-significant macular edema in diabetics with a normal lipid profile

Abstract: Atorvastatin does not affect treatment outcome in CSME with a normal lipid profile over a short term follow-up.

Cited by 17 publications

References 9 publications

The relationship between statins and diabetic retinopathy: A review of literature

The relationship between statins and diabetic retinopathy: A review of literature

Effect of atorvastatin on hard exudates in type 2 diabetic patients with normal lipid profile

‘Statins in retinal disease’

Contact Info

Product

Resources

About