ArticleInternational journal of retina and vitreous2025
Are statins a promising therapeutic strategy for macular edema? Insights from a systematic review and meta-analysis.
Article in International journal of retina and vitreous, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionMacular edema, a major cause of vision loss in diabetic retinopathy, involves retinal fluid accumulation and retinal thickening due to vascular dysfunction and inflammation. Standard treatments include anti-VEGF agents, corticosteroids, and laser photocoagulation, but limitations such as incomplete response and adverse effects exist. Statins, known for lipid-lowering and pleiotropic anti-inflammatory effects, have emerged as a potential therapeutic option.
methodsWe conducted a systematic review and meta-analysis registered with PROSPERO (CRD420251082672) following PRISMA guidelines. Peer-reviewed studies evaluating statins' efficacy and safety in macular edema were identified via multiple databases up to May 2025. Included studies encompassed randomized controlled trials and observational studies involving patients with macular edema treated with statins versus controls. Key outcomes were hard exudate reduction, retinal thickness, visual acuity, diabetic retinopathy progression, and safety.
resultsTen eligible studies involving atorvastatin and simvastatin showed statins significantly reduced hard exudates (risk ratio 4.42, p=0.03) and retinal thickness, with a 58% reduction in diabetic retinopathy progression. Statins also decreased the need for laser treatment by 32%. Visual acuity improvement was inconsistent, with benefits mainly in dyslipidemic patients. Safety analysis revealed no significant increase in adverse events. Statin effects were more pronounced in patients with elevated lipid levels.
conclusionStatins demonstrate promising anatomical and preventive benefits in diabetic macular edema, particularly in patients with dyslipidemia, by reducing lipid exudation and stabilizing retinal vasculature. Despite limited visual acuity improvement, their favorable safety profile supports considering statins as adjunctive therapy. Further large-scale, long-term trials are warranted to confirm these findings and optimize treatment protocols.
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