Statin therapy may stave off vision-threatening diabetic retinopathy

This study evaluates the association between statin therapy and the development of diabetic retinopathy (DR) in patients with type 2 diabetes and dyslipidemia.

Study design

This population-based cohort study included in 37,894 patients with diabetes and dyslipidemia. Data from the Taiwan National Health Insurance Research Database was used to investigate the DR differences in matched cohorts receiving consistent statin therapy or no statin therapy.

Outcomes

During the study period, 2,004 patients in the statin group (10.6%) developed diabetic retinopathy compared with 2,269 patients in the nonstatin group (12.0%). The statin group had significantly lower rates of DR, nonproliferative DR, proliferative DR, vitreous hemorrhage, tractional retinal detachment and diabetic macular edema. These benefits increased with increasing statin intensity and patient adherence. The statin therapy group required significantly fewer interventions for vision-threatening diabetic eye disease and had a lower rate of major cardiovascular events.

Limitations

While this study demonstrates an association, it cannot prove causation. Additionally, serum lipid levels were not monitored so it is unclear whether the statistical benefit arises from the statin itself, the lipid-lowering effects or a combination of both. Finally, the population is primarily Asian, so the results may not hold true for other populations.

Clinical significance

Statin therapy is associated with lower incidence of DR and vision-threatening complications from diabetes. This reinforces previous data showing the ocular benefits of lipid-lowering agents. Together with their primary care providers, diabetic patients should be counseled on the potential advantages of statin therapy.