Role of statins and ascorbic acid in the natural history of diabetic retinopathy: A new, affordable therapy?

Background and Objective: Diabetic retinopathy (DR) is a worldwide health problem, and intravitreal injections of anti-inflammatory and antiangiogenic agents represent the leading therapy to effectively treat DR and its complications. However, they are expensive, invasive, and stressful for patients. This study aims to demonstrate that statins and vitamin C (alone or in combination with statins) as complementary therapy could have an impact on the nonproliferative DR (NPDR) complication rate. Patients and Methods: A retrospective review was conducted with 479 patients with NPDR. Statins and vitamin C intake were analyzed, along with the rate of diabetic macular edema (DME), vitreous hemorrhage (VH), circinate maculopathy (CM), and proliferative DR (PDR). Results: Lower DME (P = .07) and VH (P = .018) rates were observed in patients who took statins compared with those who were statin naïve. This difference was significant after accounting for vitamin C intake, with a lower rate of DME (P = .01) and VH (P = .008) in patients with statin-vitamin C combination therapy. Conclusion: Statins, alone or with vitamin C, appear to reduce the complication rate of NPDR.