title: Regression of Some High-risk Features of Age-related Macular Degeneration (AMD) in Patients Receiving Intensive Statin Treatment.
abstract: OBJECTIVE
  Age-related macular degeneration (AMD) remains the leading cause of blindness in developed countries, and affects more than 150 million worldwide. Despite effective anti-angiogenic therapies for the less prevalent neovascular form of AMD, treatments are lacking for the more prevalent dry form. Similarities in risk factors and pathogenesis between AMD and atherosclerosis have led investigators to study the effects of statins on AMD incidence and progression with mixed results. A limitation of these studies has been the heterogeneity of AMD disease and the lack of standardization in statin dosage.
  
  
  OBJECTIVE
  We were interested in studying the effects of high-dose statins, similar to those showing regression of atherosclerotic plaques, in AMD.
  
  
  METHODS
  Pilot multicenter open-label prospective clinical study of 26 patients with diagnosis of AMD and the presence of many large, soft drusenoid deposits. Patients received 80 mg of atorvastatin daily and were monitored at baseline and every 3 months with complete ophthalmologic exam, best corrected visual acuity (VA), fundus photographs, optical coherence tomography (OCT), and blood work (AST, ALT, CPK, total cholesterol, TSH, creatinine, as well as a pregnancy test for premenopausal women).
  
  
  RESULTS
  Twenty-three subjects completed a minimum follow-up of 12 months. High-dose atorvastatin resulted in regression of drusen deposits associated with vision gain (+ 3.3 letters, p = 0.06) in 10 patients. No subjects progressed to advanced neovascular AMD.
  
  
  CONCLUSIONS
  High-dose statins may result in resolution of drusenoid pigment epithelial detachments (PEDs) and improvement in VA, without atrophy or neovascularization in a high-risk subgroup of AMD patients. Confirmation from larger studies is warranted.
authors.affiliation: Retina Service, Department of Ophthalmology, Mass. Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.
authors.forename: Demetrios G
authors.initials: DG
authors.lastname: Vavvas
authors.affiliation: Retina Service, Department of Ophthalmology, Mass. Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.
authors.forename: Anthony B
authors.initials: AB
authors.lastname: Daniels
authors.affiliation: Retina Service, Department of Ophthalmology, Mass. Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.
authors.forename: Zoi G
authors.initials: ZG
authors.lastname: Kapsala
authors.affiliation: Retina Service, Department of Ophthalmology, Mass. Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.
authors.forename: Jeremy W
authors.initials: JW
authors.lastname: Goldfarb
authors.affiliation: Retina Service, Department of Ophthalmology, Mass. Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Ganotakis
authors.affiliation: Retina Service, Department of Ophthalmology, Mass. Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.
authors.forename: John I
authors.initials: JI
authors.lastname: Loewenstein
authors.affiliation: Retina Service, Department of Ophthalmology, Mass. Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.
authors.forename: Lucy H
authors.initials: LH
authors.lastname: Young
authors.affiliation: Retina Service, Department of Ophthalmology, Mass. Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.
authors.forename: Evangelos S
authors.initials: ES
authors.lastname: Gragoudas
authors.affiliation: Retina Service, Department of Ophthalmology, Mass. Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.
authors.forename: Dean
authors.initials: D
authors.lastname: Eliott
authors.affiliation: Retina Service, Department of Ophthalmology, Mass. Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.
authors.forename: Ivana K
authors.initials: IK
authors.lastname: Kim
authors.affiliation: Retina Service, Department of Ophthalmology, Mass. Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.
authors.forename: Miltiadis K
authors.initials: MK
authors.lastname: Tsilimbaris
authors.affiliation: Retina Service, Department of Ophthalmology, Mass. Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.
authors.forename: Joan W
authors.initials: JW
authors.lastname: Miller
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000188:drug therapy / Q000473:pathology; D000069059:Atorvastatin / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011446:Prospective Studies; D012163:Retinal Detachment; D015593:Retinal Drusen / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D055213:Retinal Pigment Epithelium / Q000187:drug effects* / Q000473:pathology; D012307:Risk Factors; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000187:drug effects
chemical_list: D000069059:Atorvastatin
keywords: AMD; High-dose; Reversal; Soft-drusen; Statins; Vision gain