The Association of Aspirin Use With Age-Related Macular Degeneration
What is the effect of regular aspirin use on the risk for developing age-related macular degeneration (AMD)?
A prospective analysis was conducted of data from an Australian population-based cohort with four examinations during a 15-year period (1992-1994 to 2007-2009). Participants completed a detailed questionnaire at baseline assessing aspirin use, cardiovascular disease status, and AMD risk factors. AMD was graded side-by-side from retinal photographs taken at each study visit to assess the incidence of neovascular (wet) AMD and geographic atrophy (dry AMD) according to the international AMD classification.
Of 2,389 baseline participants with follow-up data available, 257 individuals (10.8%) were regular aspirin users and 63 of the 2,389 developed neovascular AMD. Persons who were regular aspirin users were more likely to have incident neovascular AMD: the 15-year cumulative incidence was 9.3% in users and 3.7% in nonusers. After adjustment for age, sex, smoking, history of cardiovascular disease, systolic blood pressure, and body mass index, persons who were regular aspirin users had a higher risk of developing neovascular AMD (odds ratio [OR], 2.46; 95% confidence interval [CI], 1.25-4.83). The association showed a dose-response effect (multivariate-adjusted p = 0.01 for trend). Aspirin use was not associated with the incidence of geographic atrophy (multivariate-adjusted OR, 0.99; 95% CI, 0.59-1.65).
The authors concluded that regular aspirin use is associated with increased risk of incident neovascular AMD, independent of a history of cardiovascular disease and smoking.
This study found that regular aspirin use was associated with increased risk of neovascular AMD during a 15-year follow-up period, independent of history of cardiovascular disease, smoking, and other potential AMD risk factors. These results confirm the findings from the European cross-sectional survey that reported a twofold increased prevalence of neovascular AMD among regular aspirin users. This potential risk, however, appears small (9.3% after 15 years), and should be balanced with the significant morbidity and mortality of suboptimally treated cardiovascular disease; any decision concerning aspirin therapy needs to be individualized, taking into account overall risk/benefit.
Keywords: Odds Ratio, Follow-Up Studies, Morbidity, Cross-Sectional Studies, Blood Pressure, Smoking, Prevalence, Body Mass Index, Geographic Atrophy, Australia, Cardiovascular Diseases, Macular Degeneration, Confidence Intervals, Neovascularization, Pathologic
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