Statin Use and Age-related Macular Degeneration: A Systematic Review and Meta-Analysis of Disease Outcomes

TOPIC: This systematic review and meta-analysis evaluated the association between statin use and the prevalence, incidence, and progression of age-related macular degeneration (AMD). CLINICAL RELEVANCE: AMD is a major cause of vision loss in older adults, many of whom receive statins for cardiovascular prevention. METHODS: We searched PubMed, Embase, Scopus, Web of Science, and the Cochrane Library through October 2025 for randomized trials and cohort, case-control, and cross-sectional studies with comparators. We assessed risk of bias with tools appropriate to each design and pooled effect measures separately using random-effects models. The protocol was registered in PROSPERO. RESULTS: Twenty-eight studies included 1,918,120 participants. Pooled odds ratios (ORs) for the prevalence of any, early, and late AMD were 1.03 (95% confidence interval [CI], 0.86-1.24), 1.10 (95% CI, 0.92-1.31), and 0.75 (95% CI, 0.46-1.25), respectively. For incidence of any AMD, the pooled hazard ratio (HR) was 1.04 (95% CI, 0.82-1.31) and the OR was 0.76 (95% CI, 0.43-1.34), with substantial heterogeneity. For neovascular AMD incidence, different study subsets suggested lower hazard (HR, 0.72; 95% CI, 0.60-0.85) and higher risk (risk ratio, 1.31; 95% CI, 1.18-1.44); the OR was inconclusive (0.93; 95% CI, 0.82-1.05). Progression evidence was limited and heterogeneous. Ten of 12 longitudinal nonrandomized studies had serious overall risk of bias. CONCLUSION: The evidence was of very low certainty and insufficient to establish a protective or harmful effect of statins on AMD. These findings do not support prescribing statins specifically for AMD or discontinuing otherwise indicated therapy.