Use of Statins and Angiotensin Converting Enzyme Inhibitors (ACE-Is) and the Risk of Age-Related Macular Degeneration: Nested Case-Control Study

Mahyar      Etminan; James   M.   Brophy; David      Maberley

Abstract

Background: Age related macular degeneration (AMD) is a progressive degenerative disease affecting central vision. Recent studies have shown that that statins may lower the risk of AMD potentially due to statins antiinflammatory and anti-oxidative properties. We sought to further explore this association and also explore the role of angiotensin- converting enzyme inhibitors (ACE-Is) with respect to the development of AMD. Methods: We conducted a nested case-control study within a cardiovascular cohort that had undergone revascularization interventions in the Province of Quebec, Canada. Cases were identified as those with an ICD-9 code for AMD. For each case, four controls were randomly chosen from the cohort and matched to the cases by age and calendar time. Conditional logistic regression was used to estimate rate ratios and adjust for potential confounders. Results: Our nested case-control study consisted of 2,867 cases and 11,468. Current users of ACE-Is or statins were at a slightly higher risk of developing AMD (1.19 [1.07-1.33]) and (1.30 [1.17-1.44]) respectively. The results were similar for those using these drugs in the year prior. Conclusions: Based on the results of our study, statin and ACE-I use may be associated with an increase in the risk of AMD. Given that our study is an observational study, further studies are required to confirm or refute these findings.

Keywords: HMG-CoA reductase Inhibitors, statins, lipid-lowering agents, macular degeneration, case control studies

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