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Safety and Efficacy of Anti-Cholesterol Medication in Soft Drusen Patients

Safety and Efficacy of Anti-Cholesterol Medication in Soft Drusen Patients. Kontari , Ioanna MD 1 Georgalas , Ilias , MD 1 Kanellopoulos, Anastasios - John MD 1,2 1 : Laservision.gr Institute, Athens, Greece 2 : NYU Medical School, New York, NY

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Safety and Efficacy of Anti-Cholesterol Medication in Soft Drusen Patients

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  1. Safety and Efficacy of Anti-Cholesterol Medication in Soft DrusenPatients Kontari, IoannaMD 1 Georgalas, Ilias, MD 1 Kanellopoulos, Anastasios-John MD 1,2 1: Laservision.gr Institute, Athens, Greece 2: NYU Medical School, New York, NY Financial Interests: Kontari: none; Georgalas: none, Kanellopoulos: Alcon/WaveLight, Avedro

  2. To investigate hypolipidaemic (cholesterol-lowering) statin effect in patients with ‘soft’ macular degeneration (Drusen). Purpose Setting • a modern ophthalmological surgical center.

  3. Background • Atorvastatin calcium (AC) is a cholesterol-lowering medication that lowers high levels of cholesterol and triglycerides in the blood, which helps reduce risk of heart disease. • The study will investigate the effects of AC on macular degeneration and on visual acuity improvement.

  4. AMD Pathology • Understanding of AMD pathology is rather incomplete • Matrix of risk factors • hereditary/ • non hereditary/environmental • Age • Smoking • Diet • Hypertension • Serum-Cholesterol levels • Cardiovascular disease

  5. AMD Pathology • Lipoproteins – synthesis at liver • Plasma: source of lipoproteins, accumulating in Bruch’s membrane • Drusen: contain* • material derived from RPE, choroid, plasma, • apolipoproteins, cholesterol, et cetera • * EbrahimiKB, Handa JT. • Lipids, lipoproteins, and age-related macular degeneration. J Lipids. 2011;2011:802059.

  6. Methods • This is a single center, comparison, single intervention case series, • 8 consecutive cases • 12 months follow up

  7. Eligibility Criteria • Age ≥ 50, • Clinical findings of hypercholesterolaemia (≥ 220 mg/dl), • Best-corrected distance visual acuity between 0.3 and 0.7, • Soft Drusenmacular findings (dry AMD), • No eye previously been treated with anti-vascular endothelial growth factor medications, • Phackic eyes.

  8. Methods • Posterior Segment Exam protocol: • Optical coherence tomography documentation of existing (pre-medicative) condition of dry AMD (soft Drusen macular findings ), • three months and six months post-medicative follow-up per patient.

  9. Medication • 40 mgr /day per os • 6-month administration • In cooperation with attending physician • Mean age 67 ± 13 (55 to 72) years, • 5 female, 3 male patients,

  10. Results • Pre-medication data • Cholesterol 265 ± 45 (225 to 290) mg/dl • Mean IOP 16.2 ± 2.1 (14 to 21) mmHg, • Mean CDVA 0.55 ± 2 (0.4 to 0.7), • Post-medication data • Cholesterol 235 ± 17 (205 to 250) mg/dl (p < 0.05), • Mean IOP 16.3 ± 2.2 (14 to 21) mmHg (p = 0.195), • Mean CDVA 0.62 ± 2 (0.5 to 0.8) (p = 0.05).

  11. Results Post-medication Pre-medication

  12. Conclusions • Administration of anti-cholesterol medication appears to have collateral benefit in stabilization and/or reduction of existing soft-Drusen AMD • More vigorous studies, extended follow-up, and larger sample investigation is recommended.

  13. Thank you www.laservision.gr

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