Use of lipid-lowering agents for the prevention of age-related macular degeneration: a meta-analysis of observational studies.
OBJECTIVE
To examine the effect of lipid-lowering agents in the development of age-related macular degeneration (AMD) through the techniques of meta-analysis.


METHODS
Case-control and cohort studies presenting relative risks and 95% confidence intervals were identified through a literature review. Inclusion was limited to studies where both the exposure of interest (lipid-lowering agents) and outcome (AMD) were explicitly defined. Pooled estimates were computed using the random effects model. To quantify heterogeneity we calculated the proportion of total variance of between study variance using the Ri statistic. The Q statistic for heterogeneity was also calculated.


RESULTS
Eight studies were identified. The pooled relative risk (RR) for all studies was 0.74 (95% CI, 0.55-1.00). When only those studies examining the use of statins were pooled (n=7), the RR was 0.70 (95% CI, 0.48-1.03). Using the Ri statistic, the heterogeneity between studies was found to be 0.85 for all studies and 0.89 for studies examining statins.


CONCLUSIONS
Lipid-lowering agents, including statins, do not appear to lower the risk of developing AMD, although clinically significant effects cannot be excluded. The use of these agents in the prevention of AMD cannot be recommended until well designed prospective studies with long follow up have demonstrated a benefit.
Chuo
Jean Y
JY
Department of Ophthalmology and Visual Sciences, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. chuo@interchange@ubc.ca
Wiens
Matthew
M
Etminan
Mahyar
M
Maberley
David A L
DA
D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008268:Macular Degeneration / Q000517:prevention & control*; D016896:Treatment Outcome
D000960:Hypolipidemic Agents