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Editors Selection IGR 9-2
Medical Treatment: Simvastatin in NTG
Comment by Christopher Girkin on:
25245 Simvastatin and Disease Stabilization in Normal Tension Glaucoma: A Cohort Study, Leung DY; Li FC; Kwong YY et al., Ophthalmology, 2010; 117: 471-476
Leung et al. (268) present the results of a prospective cohort study carried out in a Chinese population to determine if cholesterol-lowering therapy with simvastatin reduced the rate of progression in patients with normal tension glaucoma. In the study of 256 patients, 31 were taking simvastatin (12.1%). Baseline variables associated with disease progression were similar between groups. A total of 121 patients progressed on visual fields by CNTGS criteria (47.3%). Simvastatin was significantly protective against the development of progressive normal-tension glaucoma (RR: 3.26 95% confidence interval: 1.21-8.76). This cohort study joins a growing literature of retrospective data that has strongly suggested a link between hypercholesterolemia and its treatment with the development of glaucoma and provides importance evidence suggesting a potential beneficial effect of cholesterol-lowering agents in the management of glaucoma. Given the extensive clinical experience with cholesterol lowering agents, their widespread current use and favorable side-effect profile, the authors are correct to urge for the development of a larger randomized clinical trial.
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