The Relationship between Statin and Risk of Age-Related Macular Degeneration: A Systematic Review and Meta-Analysis

Abstract

Introduction and Aim. Age-related macular degeneration (AMD) is one of the leading causes of blindness and visual defect, particularly in elderly people across the world. This meta-analysis aimed at investigating the relationship between statin and the risk of AMD. Methods. Web of Science, PubMed, and Scopus databases were searched for articles that addressed the relationship between statin consumption and risk of AMD. The pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using a random-effects model. Subgroup analyses and sensitivity analyses were also conducted. Cochran’s Q test and the I2 statistic were used to evaluate the heterogeneity. To assess potential publication bias, Begg’s test was used. Results. In total, 22 studies were reviewed in the meta-analysis that included 2063195 participants and 313702 (15.20%) AMD patients compared to individuals not receiving statins. The OR of AMD in statin-receiving participants was 0.93 (95% CI; 0.83–1.05, P = 0.225 ). The OR of AMD in those that received statins was 0.92 (95% CI; 0.75–1.13, P = 0.440 ) in case-control studies, 0.95 (95% CI; 0.82–1.09, P = 0.458 ) in cohort studies, 0.951 (95% CI; 0.59–1.53, P = 0.831 ) in cross-sectional studies, 0.94 (95% CI; 0.80–1.10, P = 0.468 ) in North America, 0.81 (95% CI; 0.54–1.21, P = 0.308 ) in Europe, 1.05 (95% CI; 0.94–1.18, P = 0.362 ) in Asia, and 0.52 (95% CI; 0.26–1.04, P = 0.125 ) in Australia. No publication bias was observed in this study ( P = 0.114 ). Conclusion. According to the results of this study, taking statins does not increase or decrease the risk of AMD development. Therefore, this drug group cannot be considered a protective or risk factor for the occurrence of AMD.

Association of lipid-lowering drugs and antidiabetic drugs with age-related macular degeneration: a meta-analysis in Europeans

“…[28] One recent review maintains the potentially beneficial role of statins in AMD while underscoring the complexity of underlying associations, [53] , while two others could not confirm an association. [54,55] Our study supports the body of evidence suggesting a beneficial association with AMD and represents, to our knowledge, the first study metaanalyzing individual level data from various population-and hospital-based studies instead of meta-analyzing published aggregated results only. Yet, further longitudinal data are needed to confirm our findings, which are inherently limited by using cross-sectional data only and cannot infer causality.…”

The Effect of Statins on Ocular Disorders: A Systematic Review of Randomized Controlled Trials

“…In general, this meta-analysis supported that statins had a protective role for both early and exudative AMD [ 46 ]. However, a recent systematic review and meta-analysis that aimed to link statins and AMD led to a different conclusion [ 47 ]. Researchers reviewed a total of 22 studies, with 2,063,195 participants, 15.2% of whom were diagnosed with AMD.…”

“…The OR of AMD in those that received statins were 0.92 (95% CI; 0.75–1.13, p = 0.440) in case-control studies, 0.95 (95% CI; 0.82–1.09, p = 0.458) in cohort studies, and 0.951 (95% CI; 0.59–1.53, p = 0.831) in cross-sectional studies. This meta-analysis showed that statin therapy has no positive or negative impact on AMD development [ 47 ].…”

Cholesterol metabolism: physiological regulation and diseases

“…To achieve reduced cholesterol biosynthesis, it is necessary to inhibit the key rate-limiting enzymes in the synthesis pathway. Although studies have shown that statins do not increase or reduce the risk of AMD, 193,194 a recent study has demonstrated that simvastatin can inhibit the biosynthesis of retinal cholesterol, which is valuable for future clinical research on statins as potential treatment methods for AMD. 195 Additionally, DHCR24 inhibitors can also reduce the TC content in the retina.…”