AI Article Synopsis
- The study aims to determine if simvastatin helps stabilize visual fields in patients with normal tension glaucoma.
- The research involved 256 Chinese subjects monitored over 36 months, assessing visual field progression and various clinical factors.
- Results showed that simvastatin users had a lower rate of visual field progression compared to non-users, suggesting it may have a protective effect against visual decline in these patients.
Article Abstract
Purpose: To investigate whether simvastatin use is associated with visual field (VF) stabilization in patients with normal tension glaucoma (NTG).
Design: Prospective cohort study (ClinicalTrials.gov Identifier: NCT00321386).
Participants: A total of 256 eyes from 256 Chinese subjects with NTG.
Methods: Patients were followed up at 4-month intervals for 36 months for VF progression per Anderson's criteria. Clinical parameters were checked for association with progression in multivariate analysis.
Main Outcome Measures: The primary outcome was the association between simvastatin use and VF progression.
Results: Thirty-one patients (12.1%) were taking simvastatin (statin+), and 225 patients (87.9%) were not taking simvastatin (statin-). Baseline age, gender, untreated intraocular pressure, VF indices, vertical cup-to-disc ratio, and central corneal thickness (CCT) were comparable between the 2 groups. There were significantly more patients with a history of hypercholesterolemia, systemic hypertension, and ischemic heart disease in the statin+ group. A total of 121 patients (47.3%) showed evidence of VF progression (mean rate of mean deviation loss was -0.30 decibel per year) during the 36 months of follow-up. Simvastatin use was among 8 of 121 patients (6.6%) who progressed compared with 23 of 135 patients (17.0%) who did not progress (P = 0.011). Logistic regression revealed that history of disc hemorrhage (relative risk [RR] 3.26; 95% confidence interval [CI], 1.21-8.76; P = 0.019), history of cerebrovascular accidents (RR 2.28; 95% CI, 1.03-5.06; P = 0.043), and baseline age (per 10 years older; RR 1.38; 95% CI, 1.08-1.76; P = 0.009) were significant risk factors for VF progression, whereas simvastatin use conferred a protective effect (RR 0.36; 95% CI, 0.14-0.91; P = 0.030).
Conclusions: Simvastatin use may be associated with VF stabilization in patients with NTG. A larger scale randomized controlled trial and cost-effectiveness analyses seem warranted.
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| http://dx.doi.org/10.1016/j.ophtha.2009.08.016 | DOI Listing |
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