Advertisement

Statins improve visual field alterations related to hypercholesterolemia

      Abstract

      Objective

      To determine whether lipid-lowering treatment with diet or statins would provide beneficial effects on visual field alterations associated with hypercholesterolemia.

      Methods

      180 subjects with hypercholesterolemia were randomly assigned to a low fat diet (diet group) or to a low fat diet plus 40 mg/day of pravastatin (pravastatin group). At the beginning of the study and 6 months after the assigned treatment, all subjects underwent a computerized perimetry test and a determination of plasma concentration of glucose, total cholesterol, LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C) and triglycerides.

      Results

      At 6 months, both groups showed a significant decrease in total cholesterol, LDL-C and triglycerides compared to basal values, and a significant increase in the HDL-C. The pravastatin group had a significantly greater reduction in total cholesterol (−85 ± 21 mg/dl) and LDL-C (−86 ± 23 mg/dl) than the diet group (−28 ± 9 and −28 ± 10 mg/dl, respectively). All perimetry parameters improved in both groups after the intervention period, although the improvement was greater in the pravastatin group. Using a general linear model, a significant effect of treatment with pravastatin compared to diet was observed in the improvement of all the perimetry parameters, whereas the change in LDL-C concentrations only had a significant effect on the improvement of one of them.

      Conclusion

      In subjects with hypercholesterolemia, the decrease of blood lipids improves visual field parameters. The major beneficial effect noted with pravastatin, compared to diet, suggests that this effect could be due to the lipid-lowering and pleiotropic actions.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Atherosclerosis
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Meyer J.S.
        • Terayama Y.
        • Konno S.
        • Akiyama H.
        • Margishvili G.M.
        • Mortel K.F.
        Risk factors for cerebral degenerative changes and dementia.
        Eur Neurol. 1998; 39: 7-16
        • Kawamata T.
        • Akiguchi I.
        • Yagi H.
        • Irino M.
        • Sugiyama H.
        • Akiyama H.
        Neuropathological studies on strains of senescence accelerated mice with age-related deficits in learning and memory.
        Exp Gerontol. 1997; 32: 161-169
        • Akiyama H.
        • Meyer J.S.
        • Mortel K.F.
        • Terayama Y.
        • Thornby J.I.
        • Konno S.
        Normal human aging: factors contributing to cerebral atrophy.
        J Neurol Sci. 1997; 152: 39-49
        • Menge T.
        • Hartung H.P.
        • Stüve O.
        Statins—a cure-all for the brain?.
        Nat Rev Neurosci. 2005; 6: 325-331
        • Ong J.M.
        • Zorapapel N.C.
        • Rich K.A.
        • et al.
        Effects of cholesterol and apolipoprotein E on retinal abnormalities in ApoE-deficient mice.
        Invest Ophthalmol Vis Sci. 2001; 42: 1891-1900
        • Boesze-Battaglia K.
        • Albert A.D.
        Cholesterol modulation of photoreceptor function in bovine retinal rod outer segments.
        J Biol Chem. 1990; 265: 20727-20730
        • Hyman B.T.
        • Haimann M.H.
        • Armstrong M.L.
        • Spector A.A.
        Fatty acid and lipid composition of the monkey retina in diet-induced hypercholesterolemia.
        Atherosclerosis. 1981; 40: 321-328
        • Tomida K.
        • Tamai K.
        • Matsuda Y.
        • Matsubara A.
        • Ogura Y.
        Hupercholesterolemia induces leukocyte entrapment in the retinal microcirculation of rats.
        Curr Eye Res. 2001; 23: 38-43
        • Alcalá A.
        • Jansen S.
        • Farkouh M.
        • Morell M.
        Hypercholesterolemia is associated with visual field alterations detectable with computerized perimetry.
        Atherosclerosis. 2007; 195: e167-e171
        • Honjo M.
        • Tanihara H.
        • Nishijima K.
        • et al.
        Statin inhibits leukocyte-endothelial interaction and prevents neuronal death induced by ischemia-reperfusion injury in the rat retina.
        Arch Ophthalmol. 2002; 120: 1707-1713
        • Hayashi T.
        • Hamakawa K.
        • Nagotani S.
        • et al.
        HMG CoA reductase inhibitors reduce ischemic brain injury of Wistar rats through decreasing oxidative stress on neurons.
        Brain Res. 2005; 1037: 52-58
        • Chen J.
        • Zhang Z.G.
        • Li Y.
        • et al.
        Statins induce angiogenesis, neurogenesis and sinaptogenesis after stroke.
        Ann Neurol. 2003; 53: 743-751
        • Alcalá A.
        • Morell M.
        • Rius F.
        Comparative study of the impact of diet versus pravastatin on colour vision in Brodman area 19 detected by computerized chromatic analysis (CARDIOCOLOUR study).
        Rev Esp Cardiol. 2002; 55: 1243-1250
        • Vollmer T.
        • Key L.
        • Durkalski V.
        • et al.
        Oral simvastatin treatment in relapsing-remitting multiple sclerosis.
        Lancet. 2004; 363: 1607-1608
        • Wolozin B.
        • Kellman W.
        • Ruosseau P.
        • Celsia G.G.
        • Siegel G.
        Decreased prevalence of Alzheimer disease associated with 3-hydroxy-3-methylglutaril coenzyme A reductase inhibitors.
        Arch Neurol. 2000; 57: 1439-1443
        • National Cholesterol Education Program
        Second report of the expert panel of detection, evaluation and treatment of high blood cholesterol in adults (adults treatment panel II).
        Circulation. 1994; 89: 1329-1445
        • Wild J.M.
        • Dengler-Harles M.
        • Searle A.E.
        • O’Neill E.C.
        • Crews S.J.
        The influence of the learning effect on automated perimetry in patients with suspected glaucoma.
        Acta Ophthalmol Scand. 1990; 68: 681-686
        • Olsson J.
        • Bengtsson B.
        • Heijl A.
        • Rootzen H.
        An improved method to estimate frequency of false positive answers in computerized perimetry.
        Acta Ophthalmol Scand. 1997; 75: 181-183
        • Heijl A.
        • Lindgren G.
        • Olsson J.
        The effect of perimetric experience in normal subjects.
        Arch Ophthalmol. 1989; 107: 81-86
        • Johnson-Anuna L.N.
        • Eckert G.P.
        • Keller J.H.
        • et al.
        Chronic administration of statins alters multiple gene expression patterns in mouse cerebral cortex.
        J Pharmacol Exp Ther. 2005; 312: 786-793
        • Vuletic S.
        • Riekse R.G.
        • Marcovina S.M.
        • Peskind E.R.
        • Hazzard W.R.
        • Albers J.J.
        Statins of different brain penetrability differentially affect CSF PLTP activity.
        Dement Geriatr Cogn Disord. 2006; 22: 392-398
        • Quion J.A.
        • Jones P.H.
        Clinical pharmacokinetics of pravastatin.
        Clin Pharmacokinet. 1994; 27: 94-103
        • Crouse III, J.R.
        • Byington R.P.
        • Furberg C.D.
        HMG-CoA reductase inhibitor therapy and stroke risk reduction: an analysis of clinical trial data.
        Atherosclerosis. 1998; 138: 11-24
        • The Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Investigators
        High-dose atorvastatin after stroke or transient ischemic attack.
        N Engl J Med. 2006; 355: 549-559
        • Cucchiara B.
        • Kasner S.E.
        Use of statins in CNS disorders.
        J Neurol Sci. 2001; 187: 81-89
        • Takemoto M.
        • Liao J.K.
        Pleiotropic effects of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors.
        Arterioscler Thromb Vasc Biol. 2001; 21: 1712-1719
        • Liao J.K.
        Statins and ischemic stroke.
        Atheroscler Suppl. 2002; 3: 21-25
        • Song J.
        • Deng P.F.
        • Stinnett S.S.
        • Epstein D.L.
        • Rao P.V.
        Effects of cholesterol-lowering statins on the aqueous humor outflow pathway.
        Invest Ophthalmol Vis Sci. 2005; 46: 2424-2432
        • McGwin Jr., G.
        • McNeal S.
        • Owsley C.
        • Girkin C.
        • Epstein D.
        • Lee P.P.
        Statins and other cholesterol-lowering medications and the presence of glaucoma.
        Arch Ophthalmol. 2004; 122: 822-826
        • Oh S.W.
        • Lee S.
        • Park C.
        • Kim D.J.
        Elevated intraocular pressure is associated with insulin resistance and metabolic syndrome.
        Diabetes Metab Res Rev. 2005; 21: 434-440