JAMA Internal Medicine: Macular Disorders Topic Collection

The Association of Aspirin Use With Age-Related Macular Degeneration Association of Aspirin With Macular Degeneration

Liew G, Mitchell P, Wong T, et al. — Mon, 25 Feb 2013 00:00:00 GMT

Objective

To determine whether regular aspirin use is associated with a higher risk for developing age-related macular degeneration (AMD) by using analyzed data from a 15-year prospective cohort.

Methods

A prospective analysis was conducted of data from an Australian population-based cohort with 4 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.

Results

Of 2389 baseline participants with follow-up data available, 257 individuals (10.8%) were regular aspirin users and 63 of the 2389 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).

Conclusion

Regular aspirin use is associated with increased risk of incident neovascular AMD, independent of a history of cardiovascular disease and smoking.

Relationship of Aspirin Use With Age-Related Macular Degeneration: Association or Causation? Comment on “The Association of Aspirin Use With Age-Related Macular Degeneration” Aspirin and AMD: Association or Causation?

Kaul S, Diamond GA. — Mon, 25 Feb 2013 00:00:00 GMT

In their prospective population-based cohort study of 2389 patients in the Blue Mountains region in Australia, Liew and colleagues report on the association of long-term use of low-dose aspirin and age-related macular degeneration (AMD), the leading cause of blindness in Western countries. The principal finding is that regular aspirin use is associated with an approximately 2.5-fold greater risk of incident AMD. This relationship is specific for late neovascular (wet) AMD but not geographic atrophy (dry AMD) and is independent of potential confounders, such as cardiovascular disease, smoking, age, sex, systolic blood pressure, and body mass index.

In This Issue of JAMA Internal Medicine

Mon, 25 Feb 2013 00:00:00 GMT