Atorvastatin: A Drusen Disintegrator?
Brianne N. Hobbs, OD
Regression of Some High-Risk Features of Age-Related Macular Degeneration (AMD) in Patients Receiving Intensive Statin Treatment
Although the effects of atorvastatin in the initial case report were encouraging, the results of the pilot trial were less so.
Vavvas DG, Daniels AB, Kapsala ZG, et al
EBioMedicine. 2016 Feb 9. [Epub ahead of print]
Age-related macular degeneration (AMD) is the leading cause of blindness in Americans older than 65 years. Heart disease is the leading cause of death in the United States.
Of note, these two conditions may share a common pathogenesis. The Bruch membrane may be conceptualized as analogous to the vascular intima of blood vessels; therefore, cholesterol may accumulate in the Bruch membrane just as it does in the vessel walls in atherosclerosis, the most common cause of heart disease.
The logical assumption is that statins may help treat AMD, but the results have been conflicting thus far. This new study may help change the way in which we manage dry AMD.
The study conducted by Vavvas and colleagues was based on the outcome of high-dose statin treatment in a 63-year-old man who experienced a 12-letter visual acuity gain and complete resolution of his soft drusen within 12 months of beginning treatment.
On the basis of these dramatic results, the investigators enrolled 23 participants with large, soft drusenoid pigment epithelial detachments into a trial where all participants received 80 mg of atorvastatin daily. The minimum duration of treatment with atorvastatin was 1 year.
A complete eye examination, including fundus photographs and optical coherence tomography, was performed every 6 months. The primary outcome measure was drusen volume reduction by > 50%.
Although the effects of atorvastatin in the initial case report were encouraging, the results of the pilot trial were less so…….
Read more: http://www.medscape.com/viewarticle/859235