Aspirin could be contributing to AMD: Sydney based research

The institute’s Centre for Vision Research studied 2,389 people over a 15-year period and discovered 63 developed neovascular, or late-stage, AMD.
According to the centre’s director, Professor Paul Mitchell, 9.3% of regular aspirin users in the study developed the condition after 15 years, compared with 3.7% of those who did not take aspirin regularly.
That translated to a 2.5-fold risk for regular aspirin users, Professor Mitchell said on 22 January.
Aspirin is used widely to prevent heart attack and stroke but the research at the Centre for Vision Research has raised concerns that aspirin could be contributing to eye disease. Professor Mitchell said the study, published in the journal JAMA Internal Medicine, could not conclude aspirin was the cause of the AMD.
It would therefore be prature for clinicians to change their practice around recommending aspirin use, he said.
“But this is another possible adverse event of aspirin. Aspirin has been put forward as something that just about everyone should take.
“It’s findings like this that suggest we should be cautious about going down that path.” Professor Mitchell said three other international studies had found similar results suggesting a link between regular aspirin use and AMD and that it could be that conditions such as heart probls for which people took aspirin were associated with macular degeneration.
“More vigorous studies are needed to test the findings further,” he said.
Aspirin has been shown to be beneficial in the prevention of recurrent heart disease, including heart attack and stroke, and is one of the most widely used medications worldwide, with more than 100 billion tablets consumed each year.
The objective of the study was to determine whether regular aspirin use is associated with a higher risk for developing AMD by using analysed data from a 15-year prospective cohort.
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.
Age-related macular degeneration 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 2389 baseline participants with follow-up data available, 257 individuals (10.8%) were regular aspirin users and 63 of these (24.5%) 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% CI, 1.25-4.83). The association showed a dose-response effect (multivariate-adjusted P = .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 researchers concluded that regular aspirin use is associated with increased risk of incident neovascular AMD, independent of a history of cardiovascular disease and smoking.