Statins prevent from and halt progression of retinopathy in diabetes: JAMA

According to a large cohort study from Taiwan, Statins therapy significantly decreased risk of diabetic retinopathy in patients with type 2 diabetes and high cholesterol. It was also associated with a lower need for invasive treatments for vision-threatening diabetic retinopathy, and its benefits were dose dependent.The new study has been published online in JAMA Ophthalmology

Yih-Shiou Hwang, MD, PhD, of Chang Gung Memorial Hospital in Taoyuan, Taiwan, and colleagues conducted the population-based cohort study to the association of statin therapy with development of diabetic retinopathy in patients with type 2 diabetes and dyslipidemia and to assess statin use for the primary prevention of the eye disorder.

Diabetic retinopathy is a leading microvascular complication of diabetes. According to one estimate, as many as 191 million people worldwide will have developed the vision-threatening eye disorder by 2030

While several studies in the past have suggested that statin treatment slows progression of diabetic retinopathy in patients with diabetes and dyslipidemia, the new study is among the first to assess statin use for the primary prevention of the eye disorder.

The researchers used the National Health Insurance Research Database (NHIRD) of longitudinal claims data from medical practices receiving payment from the single-payer Taiwan National Health Insurance.Out of 1,648,305 patients with type 2 diabetes recorded in the database from 1998 through 2013, a total of 219,359 were eligible for the analysis, including 199,760 patients taking statins and 19,599 not taking statins.

During the study period, 2,004 patients in the statin group (10.6%) and 2,269 in the non-statin group (12.0%) developed diabetic retinopathy.

The researchers found that

1. Patients in the statin group had a significantly lower rate of diabetic retinopathy compared with patients in the nonstatin group


2. Patients also had lower rates of vitreous hemorrhage , tractional retinal detachment , and macular edema .


3. Compared with the nonstatin group, the statin users had lower rates of interventions such as retinal laser treatment , intravitreal injection , and vitrectomy .

They further found that Statin use was associated with lower risks of major adverse cardiovascular events , new-onset diabetic neuropathy , and new-onset diabetic foot ulcers .

"In our study, we found that statin therapy alone was associated with a reduced risk of diabetic retinopathy compared with the nonstatin group," the researchers wrote. "Our finding could expand the conclusion from the ACCORD-EYE study that the group receiving statins and fenofibrate had the lowest risk of diabetic retinopathy (6.5% in the ACCORD-EYE study) followed by the group receiving statins alone (10.6% in our study and 10.2% in the ACCORD-EYE study)."

"Our study and the ACCORD-EYE study could offer medical strategies to reduce the risk of diabetic retinopathy," the team added.

For further Reference log on to: DOI: 10.1001/jamaophthalmol.2018.6399.