Aspirin use linked to macular degeneration
Aspirin is commonly used for pain relief and to decrease the risk of cardiovascular studies; in addition, studies have reported that it may reduce the risk of other conditions such as cancer and dementia. However, a new study has linked regular aspirin use to an increased risk of the most severe form of macular degeneration, neovascular macular degeneration, which results in vision loss. Researchers affiliated with the University of Wisconsin published their findings in the December 19 edition of the Journal of the American Medical Association.
The macula is the central portion of the retina. Macular degeneration results in blurred central vision and individuals with the condition have difficulty distinguishing fine details. Neovascular macular degeneration is the severest form of macular degeneration. Fortunately, however, it is also the rarest form of the disease. The study found that regular aspirin use doubled the risk of developing neovascular macular degeneration.
The researchers accessed data from the Beaver Dam Eye Study, which is a longitudinal population-based study of age-related eye diseases conducted in Wisconsin. Eye examinations were performed every five years over a 20-year period (1988-1990 through 2008-2010). The study group comprised 4,926 individuals aged 43 to 86 years at the baseline examination. At subsequent examinations, the participants were asked if they had regularly used aspirin at least twice a week for more than three months. The main outcome measure was the incidence of early macular degeneration, late macular degeneration, and tow subtypes of late macular degeneration (neovascular macular degeneration and pure geographic atrophy). The severity of macular degeneration was assessed with retinal photographs according to the Wisconsin Age-Related Maculopathy Grading System.
The average duration of follow-up was 14.8 years. The researchers identified 512 cases of early macular degeneration (of 6,243 person-visits at risk) and 117 cases of late macular degeneration (of 8,621 person-visits at risk) over the course of the study. They found that regular aspirin use 10 years prior to retinal examination was associated with late macular degeneration (hazard ratio: 1.63), with estimated incidence of 1.76% in regular users and 1.03% in nonusers. For subtypes of late macular degeneration, regular aspirin use 10 years prior to retinal examination was significantly associated with neovascular macular degeneration (hazard ratio: 2.20 but not pure geographic atrophy. Aspirin use for five years prior to retinal examination was not associated with incident early AMD.
The authors concluded: “Among an adult cohort, aspirin use 5 years prior to observed incidence was not associated with incident early or late AMD. However, regular aspirin use 10 years prior was associated with a small but statistically significant increase in the risk of incident late and neovascular AMD.
Take home message:
This study notes that long-term aspirin use increases the risk of neovascular macular degeneration. The overall risk of the condition is one in 200 older Americans. Regular aspirin use increases that risk to about one in 100. Although this is still a small risk, it is a significant increase because one in five US adults takes aspirin either on a regular basis to ward off diseases such as heart disease and some cancers. For individuals with cardiovascular risk factors, the benefit of aspirin far outweighs the risk. Blurred vision is not life-threatening; however, a heart attack or stroke is.
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