title: Statin use and the risk of age related macular degeneration in a large health organization in Israel.
abstract: OBJECTIVE
  To investigate the association between persistent use of statins and the risk of age-related macular degeneration (AMD).
  
  
  METHODS
  A population-based retrospective cohort among adults who began statin therapy between 1998 and 2006 in a large health organization in Israel. The organization's central computerized databases were used to collect data on incident AMD cases diagnosed by ophthalmologists.
  
  
  RESULTS
  A total of 108,973 individuals aged 55 or older were identified. During the study follow-up period 409,113 person-years, there were 2,732 incident AMD cases (6.68 per 1,000 person-years). The crude incidence density rate of AMD among patients at the lowest quintile of persistence with statins (7.18 per 1,000) was comparable to that of highest persistence quintile (7.13 per 1,000). After adjustment for potential confounders, patients in the highest quintile of persistence with statins had a hazard ratio of 0.99 (95% Confidence Interval: 0.78-1.26) for AMD compared with patients in the lowest proportion of days covered (PDC) quintile. In addition to age, AMD was found to associate with past smoking, asthma, diabetes and frequent visits to ophthalmologists or primary physicians prior to index date.
  
  
  CONCLUSIONS
  Our study agrees with previous studies that showed no association between persistent use of statins and reduced risk of AMD. These results suggest that the early reports on a strong protective effect of statins against AMD development were probably a result of a small study effect.
authors.affiliation: Maccabi Healthcare Services, Tel Aviv, Israel.
authors.forename: Varda
authors.initials: V
authors.lastname: Shalev
authors.forename: Miri
authors.initials: M
authors.lastname: Sror
authors.forename: Inbal
authors.initials: I
authors.lastname: Goldshtein
authors.forename: Ehud
authors.initials: E
authors.lastname: Kokia
authors.forename: Gabriel
authors.initials: G
authors.lastname: Chodick
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000517:prevention & control; D008078:Cholesterol, LDL / Q000097:blood; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006279:Health Maintenance Organizations / Q000706:statistics & numerical data*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000188:drug therapy; D015994:Incidence; D007557:Israel / Q000453:epidemiology; D008268:Macular Degeneration / Q000139:chemically induced / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors