Cholesterol drugs 'may save vision'

Eye drops designed to lower cholesterol may be able to prevent one of the most common forms of blindness in the aged, a new study led by Indian-origin scientist has found.

Targeting cholesterol metabolism in the eye might help prevent a severe form of age-related macular degeneration (AMD), according to indications in a mice study led by Rajendra Apte, a professor of ophthalmology and vision sciences at Washington University in St Louis.

Cholesterol build-up in arteries and veins, or atherosclerosis, occurs as a natural consequence of ageing.

Likewise, in AMD, cholesterol is known to accumulate in the eye, within deposits called drusen.

The study, published in Cell Metabolism, shows that large cells called macrophages appear to play a key role in clearing cholesterol from the eye, and that with ageing, these cells become less efficient at this task.

Eye drops containing a type of drug known to promote cholesterol release from macrophages, called a liver X receptor (LXR) agonist, helped restore macrophage function and prevent AMD progression in a mouse model.

AMD causes damage to the macula, a region of the retina responsible for central, high-resolution vision.

"This study points to a novel strategy for early intervention to prevent the progression of AMD to the severe neovascular form of the disease," said Grace Shen, a programme director at NIH's National Eye Institute.

A protein called ABCA1 is needed for macrophages to release cholesterol into the bloodstream. In these experiments on mice, Apte and his team found that in old macrophages, there is a decrease in the level of ABCA1 protein.

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