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 Researchers
found that diabetic patients taking statins were 14 percent less
likely to develop retinopathy than those who were not. And among
patients who did develop retinopathy, statin therapy was associated
with slower disease progression, according to Dr. Eugene Yu-Chuan
Kang, a researcher at Chang Gung Memorial Hospital in Taiwan, and
colleagues.
Diabetes leads to retinopathy through damage to the blood vessels in
the eyes, said Dr. Szilard Kiss, director of the retina service and
director of tele-ophthalmology at NewYork-Presbyterian/Weill Cornell
Medical Center in New York City.
Ultimately, people can go blind from diabetic retinopathy.
"The retina is like the film in a camera," explained Kiss, who was
not involved in the new study. "Diabetes causes the blood vessels to
become leaky, which causes swelling in the retina."
When the blood vessels leak, they spill a host of substances in the
blood, including cholesterol into the retina, Kiss said. As of yet,
scientists aren't sure exactly how cholesterol might be causing eye
damage.
As reported in JAMA Ophthalmology, the research team pored through
the Taiwanese National Health Insurance Database, ultimately finding
740,326 patients who had received a diagnosis of type 2 diabetes
between 1998 and 2013 and who also had high cholesterol. The
researchers winnowed that number down to 219,359 patients, 199,760
of whom were taking statins and 19,599 who were not.
The researchers ultimately settled on a comparison of 18,947
patients on statins and 18,947 who were not taking the cholesterol
lowering medications. After an average follow-up of seven years,
retinopathy had developed in 2,004 patients taking statins, or 10.6
percent, compared to 2,269, or 12 percent, of those who did not take
the medications.
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Along with a lower rate of diabetic retinopathy, statin use was also
linked with a lower need for invasive treatments for the eye
disease, the researchers reported.
Clinical trials have shown that cholesterol-lowering drugs can
impact the risk of diabetic retinopathy, Kiss said. "But this is a
very valuable type of study," he added. "It's another level of
evidence and confirms in the real world that treating dyslipidemia
can have an effect on diabetic retinopathy."
"The study reiterates the importance of treating hyperlipidemia in
the presence of diabetes," Kiss said. "We focus so much on blood
sugar in these patients, which is important of course, but we
shouldn't forget about the lipids."
It's important to remember that this is just an observational study,
said Dr. Seth Martin, a professor of medicine and director of the
advanced lipid disorders program at the Ciccarone Center for the
Prevention of Heart Disease at Johns Hopkins Medicine. As such, the
findings show an association but don't prove that statins led to
lower rates of retinopathy.
"But it's a really interesting study that was done in a large number
of patients," Martin said. Moreover, "it's reassuring that there was
decreased retinopathy in those taking statins."
In the end, Martin said, the main reason to be taking statins is to
lower the risk of heart disease. The potential impact on the eyes of
diabetic patients could be an added benefit.
"There's been a large increase in diabetes over time," Martin said.
"It's a really important condition that carries cardiovascular risk
that people often don't recognize or realize how large of a risk it
is."
SOURCE: http://bit.ly/2RIjmwp JAMA Ophthalmology, online January 10,
2019.
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