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Cholesterol-lowering statins linked with development of cataracts – diabetics on statins may be even at greater risk.

Posted by Tom Cockley | Posted on October 25, 2012

Did you know that patients on statins might be more prone to cataracts?  It’s been estimated that one in four adults 45 years and older now takes a cholesterol-lowering statin drug.  Although the benefits of statins are well known, new evidence indicates that statin users are more than 50% likelier to develop age-related cataracts according to the results of a recently released study.  And type 2 diabetics who use statins are at even greater risk of cataracts.

What does this mean to you and your patients?  We know that you keep good records of your patients’ medications.  But sometimes a patient will neglect to tell you of a new drug they are taking.  Vigilance is important!  We also know that you examine patients’ lenses religiously with your eye exams.  But with this new possible connection between statins, diabetes, and cataracts, it would be appropriate to tell patients in these categories that you are watching carefully for cataracts – even at an earlier age than you or they might expect.

For an explanation, we turn to Dr. Carolyn Machan at the University of Waterloo in Ontario.   The suggestion, according to Dr. Machan, is that the crystalline lens membrane requires cholesterol for proper epithelial cell development and lens transparency.  She and her colleagues in the August 2012 issue of Optometry and Vision Science explained “Increased cataract formation has been seen in both animals and humans with hereditary cholesterol deficiency, and the risk exists that statins can inhibit cholesterol biosynthesis in the human lens.”

Asked to comment on the study, Dr Richard Karas at Tufts University School of Medicine called the findings “an interesting observation [that] isn’t alarmist.” There is, he says, a “suggestion” here that statins may increase the risk of cataracts, but this visual problem eventually afflicts everyone of a certain age anyhow, he says, adding that further study of this association will be required.

The Waterloo Eye Study analysis included 6397 patients with and without diabetes. As the researchers noted, diabetes is a risk factor for the development of cataracts, leading the group to analyze the prevalence of cataracts among patients with diabetes taking statins and the prevalence among those taking statins but without diabetes. In the study, diabetes was associated with an 86% higher risk of developing cataracts.

A diagnosis of diabetes was also associated with an increased risk of different subtypes of cataracts: an 84% greater risk of nuclear sclerosis, a 38% higher risk of cortical cataract, and a 52% rise in posterior subcapsular cataract

Statin use was also associated with a significantly increased risk of developing age-related cataracts and some subtypes, including a 48% higher risk of nuclear sclerosis and a 48% rise in posterior subcapsular cataract but no increased risk of cortical cataract.

In an analysis of cataract prevalence among patients with and without diabetes taking statins, Machan and colleagues found that the prevalence of cataract increased at a faster rate in patients with diabetes who used statins.

Although the study should not be taken with alarm nor cause patients to delete statins from their medication routines, eye care professionals should be aware of the possible link and be diligent.

Many professionals use eye models in their explanations of cataracts. We at Gulden have an ideal eye model to demonstrate what cataracts are and what can be done when they obscure vision.  In addition, our Diabetes Eye-Plus™ Model shows not only the effects of diabetes on eyes and vision but also on other important body organs and systems.

Tell me what you think.

Be visionary with Gulden!

Gulden distributes a wide range of eye models that help vision care professionals explain and demonstrate eye diseases and conditions, including:  Cataract Models: Diabetes Eye-Plus Models;  Glaucoma Demonstrating Models, Vision Threatening Diseases Models; Retinal & Vitreous Detachment Models; plus many more.  In addition, Gulden can design, develop, and produce custom models to meet every patient and staff education need.

Click the link below to learn more about our extensive range of eye models https://guldenophthalmics.com/ccp7/Models

Excerpts printed with permission of Medscape Medical News.  View the entire article at http://www.medscape.com/viewarticle/769077

Tom Cockley is president of Gulden Ophthalmics and is the third generation of the nearly 75-year-old visionary company that brings innovative, time-saving, utilitarian products to vision and health care professionals.

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