| PICO | Description |
|---|---|
| Population | Patients with clinically significant macular edema (CSME) secondary to type 2 diabetes mellitus. |
| Intervention | Low-dose atorvastatin (10-20 mg) as adjunctive therapy to anti-VEGF treatment. |
| Comparison | High-dose atorvastatin (40-80 mg) used alongside anti-VEGF therapy. |
| Outcome | Low-dose atorvastatin significantly improved functional (e.g., visual acuity) and anatomical outcomes (e.g., retinal thickness) compared to high-dose treatment. Minimal side effects were reported for low-dose use. |
RCT
Rom J Ophthalmol · 2025
Statins as adjunct anti-VEGF for diabetic CSME
RCT · type 2 diabetes CSME · 6 months
Trial design
Change from baseline — both arms
Injections, 6 mo
3.55 vs 3.33
p=0.24, NS
BCVA gain
3 and 6 mo
Low-dose sustained
CMT reduction
Greater
Low-dose group
Serum VEGF
Down vs up
Low vs high (NS)
⬡ Bottom Line
Low-dose atorvastatin added to intravitreal ranibizumab gave better and more sustained gains in visual acuity and greater central macular thickness reduction than high-dose statin, with a similar number of injections.
P
Population
Type 2 diabetes with NPDR and clinically significant macular edema
I
Intervention
Low-dose atorvastatin (10-20 mg) plus monthly loading then PRN ranibizumab
C
Comparator
High-dose atorvastatin (30-40 mg) plus the same anti-VEGF regimen
O
Outcome
BCVA, central macular thickness, anti-VEGF injection count and serum VEGF over 6 months