Do statins offer new treatment for macular degeneration?
Age Related Macular Degeneration (ARMD) is one of the most common but least treatable eye diseases.
In 2010, the National Eye Institute reported 2.07 million cases of macular degeneration in the United States. They are projecting that figure to more than double to 5.44 million by 2050.
The macula is the central part of the retina in the back of the eye, whatever object you are looking at gets focused onto this spot in the retina.
Consequently, macular degeneration causes distortion or even blackness in a patient's central vision.
There are two forms of ARMD: wet and dry. The wet form has leaking blood vessels and fluid under the macula and can be treated with injections of medication into the eye. The dry form does not have leaking fluid but still disturbs central vision due to buildup of cellular waste in the retina and scarring in the macula.
At present, our only "treatment" of the dry form of macular degeneration is certain formulations of vitamins.
This vitamin formulation, dubbed AREDS after the name of the study conducted, has shown to stop progression of moderate dry ARMD to severe ARMD in about 25 percent of the study group. This is better than nothing, but I would definitely want better statistics if I had macular degeneration.
A new, albeit small, pilot study out of Harvard Medical School has shown some promise for those with dry ARMD. The study investigated the effects of atorvastatin (a drug many of you probably recognize for treatment of high cholesterol) on patients with moderate to severe dry ARMD.
None of the patients in this study converted to wet macular degeneration, and more than 50 percent of the patients had significant regression of their dry macular degeneration. A larger scale study will have to be conducted to evaluate long-term efficacy and safety, and to see whether the results would be repeatable in a more diverse study group.
There are also a few lifestyle changes that might be somewhat protective from ARMD. The largest modifiable risk factor for macular degeneration by far is smoking.
In addition, literature has shown a diet rich in leafy greens as helpful in lowering risk of ARMD.
A new study released last year also found those who ate more fruits and had a higher caffeine intake both had a lower incidence of macular degeneration.
We still have a long way to go in effectively treating ARMD, but there is definitely cause to be optimistic for the future.
Caroline Bundrick, O.D. is an optometrist practicing at Darling Eye Center, with offices in Bluffton and on Hilton Head.