Impact of Long-Term Statin Therapy on the Severity and Treatment of Diabetic Retinopathy in Type 2 Diabetes Mellitus

Vollständiger Abstract

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Background: Diabetic retinopathy (DR) is one of the leading microvascular complications of type 2 diabetes mellitus (T2DM) and remains a major cause of preventable vision loss worldwide. In addition to glycemic control, dyslipidemia has been implicated in the progression of retinal vascular damage. Statins, widely prescribed for lipid-lowering therapy, may provide additional protective effects against the development and progression of diabetic retinopathy. Aim: To assess the role of statin therapy in diabetic retinopathy among patients with type 2 diabetes mellitus. Methods: A cross-sectional study was conducted among 110 patients with T2DM. Comprehensive ophthalmic evaluation, including dilated fundus examination and optical coherence tomography (OCT) of the macula, was performed in both eyes. Among the participants, 80 patients had been receiving statin therapy for more than 10 years, while 30 patients had never received statin therapy. The prevalence and severity of diabetic retinopathy and diabetic macular edema (DME) were compared between the two groups. Results: The mean duration of diabetes was 17.5 ± 6.7 years. The overall prevalence of diabetic retinopathy was 46.35%. Mild non-proliferative diabetic retinopathy (NPDR) was observed in 20% of patients, moderate NPDR in 10.9%, severe NPDR in 6.36%, and proliferative diabetic retinopathy (PDR) in 9.09%. Diabetic macular edema was present in 20% of participants. Patients receiving long-term statin therapy demonstrated a lower incidence of diabetic macular edema and reduced need for treatment of diabetic retinopathy compared with those not receiving statins. Conclusion: Long-term statin therapy appears to be associated with a reduced risk of sight-threatening diabetic retinopathy and diabetic macular edema in patients with type 2 diabetes mellitus. These findings suggest that lipid-lowering therapy may contribute to delaying disease progression and reducing the need for vision-saving interventions.