Cholesterol medications reduce risk of age-related degenerative eye disease

Regular use of drugs to control cholesterol and manage type 2 diabetes may reduce the incidence of AMD, a degenerative eye disorder linked with ageing, according to a pooled data analysis of the available evidence published online in the British Journal of Ophthalmology.
These frequent drugs, according to the data, are associated with a decreased prevalence of AMD (age-related macular degeneration) in European populations. AMD is the leading cause of significant visual impairment in senior persons in high-income countries. The disease already affects 67 million people in Europe alone, and as the continent’s population ages, the number of new cases is likely to soar.

Both central vision and fine detail perception are impaired by AMD. AMD is thought to be caused by a combination of genetic and environmental ageing factors, but the best approaches to prevent or slow its progression are unknown.
Previous research has showed that drugs used to control cholesterol, manage diabetes, and reduce inflammation may help reduce the risk of developing AMD, but the results were inconsistent and based on small participant numbers.
In order to avoid these issues, the researchers combined the data from 14 population-based and hospital-based studies with 38,694 people from France, Germany, Greece, Ireland, Italy, Norway, Portugal, Russia, and the United Kingdom.

The research is part of the European Eye Epidemiology (E3) project, a pan-European collaborative network whose primary purpose is to develop and analyse large pooled datasets to better understand eye disease and vision loss.
All of the participants were over the age of 50 and were using at least one of the following medications: Levodopa is used to treat movement problems caused by neurodegenerative illnesses; statins are used to decrease cholesterol; insulin is used to manage diabetes; and steroids are used to minimise inflammation.
The prevalence of AMD in the studies evaluated ranged from 12.5% to 64.5%, totaling 9,332 cases, whereas the prevalence of advanced (late) AMD ranged from 0.5% to 35.5 percent, totaling 951.

After accounting for any potential affecting factors, the pooled data analysis found that drugs to decrease cholesterol or control diabetes were associated with a 15% and 22% lower prevalence of any kind of AMD, respectively.
Despite the limited number of such cases, the researchers emphasise that no such links were observed for any of the other medication groups or for severe AMD in particular.
The researchers claim that theirs is the first major pooled data study of its sort to incorporate individual-level data from several population-based and hospital-based studies.
“However, further longitudinal data are required to corroborate our findings, which are intrinsically constrained by utilising just cross-sectional data and cannot infer causality,” they noted.

However, the findings imply that metabolic pathways play a crucial role in the development of AMD, which may open up new paths for therapy and have consequences for public health messaging.
“According to our findings, frequent use of [lipid-lowering] and anti-diabetic medications is related with a decreased prevalence of AMD in the general population. Given the possibility of these medications interfering with pathophysiological pathways related to AMD, this may lead to a better understanding of AMD aetiology “They reached a conclusion.