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Aspirin use and age-related macular degeneration

SYDNEY, AUSTRALIA. Two studies have just appeared which associate risk of age-related macular degeneration (AMD) with regular use of aspirin. This is relevant to the above discussion where the AHA recommends regular aspirin use for secondary prevention of acute cardiovascular events. The first study by Liew et al followed approximately 2400 subjects for a 15-year period. Aspirin use was determined by a questionnaire and AMD graded by retinal photographs. At issue was the prevalence of wet AMD also called neovascular AMD. Regular aspirin use was defined as equal to or greater than once a week, occasional less than once a week and non-regular group comprised occasional and non-users. When non-regular users were compared with regular users, the number of regular users needed to produce one case of wet ADM was 91 for 5 years of use, 19 for 10 years, and 9 for 15 years. When the reference was non-users, at 15 years, the odds ratios for occasional and regular users were 1.26 and 2.46, but only the latter was statistically significance although the trend was. The odds ratios were adjusted for a number of variables considered confounders.

The second study was cross-sectional in nature (a snapshot of a group where cases were compared to non-cases). There were 96 cases with wet AMD which were compared with 2035 non-cases, all with full data on confounders. The odds ratio for daily use was 2.26 adjusted for all potential confounders and was statistically significant, whereas use for at least once a week but less than daily, the ratio was 1.30 and not statistically significant. No information was available regarding history of use. For early AMD, there was no significant association with aspirin use.

These two studies taken together suggest serious implications for millions of individuals using aspirin therapy.

Liew G, Mitchell P, Wong TY, Rochtchina E, Wang JJ. The association of aspirin use with age-related macular degeneration. JAMA Intern Med 2013 February 25;173(4):258-64
de Jong PT, Chakravarthy U, Rahu M et al. Associations between aspirin use and aging macula disorder: the European Eye Study. Ophthalmology 2012 January;119(1):112-8

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