MACULAR DEGENERATION AND ASPIRIN USE

Retina. 2017 Sep;37(9):1630-1635. doi: 10.1097/IAE.0000000000001475.

Abstract

Purpose: To review current literature of the benefits that aspirin provides for patients' cardiovascular health compared with the risk of AMD worsening.

Methods: We performed a review and critically analyzed six cardiovascular and four ophthalmological trials regarding risks and benefits of aspirin use. The prospective randomized cardiovascular trials had a cumulative 167,580 while the 3 smaller ophthalmological data sets had a cumulative 12,015 subjects.

Results: The reviewed meta-analysis literature demonstrated a statistically significant 32% reduction in the risk of nonfatal stroke with regular aspirin users. The study also documented that aspirin users decreased the risk of fatal vascular deaths by 15%. Of the three ophthalmological studies highlighting the adverse affects of aspirin association with AMD, all suggested an exacerbation of AMD without statistical significance and broad confidence bands.

Conclusion: Overall, the number, size, and quality of the cardiovascular studies recommending aspirin use are far superior to the fewer, smaller and conflicting studies suggesting a possible adverse effect of aspirin use in relation to AMD. The benefits of aspirin usage include preserving the duration and quality of life by decreasing stroke and heart attack risk. These benefits seem to far outweigh the theoretical risks of possibly exacerbating wet AMD, which can be reasonably controlled with anti-VEGF therapy.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects*
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Aspirin / adverse effects*
  • Aspirin / therapeutic use
  • Cardiovascular Diseases / drug therapy
  • Fibrinolytic Agents / adverse effects*
  • Fibrinolytic Agents / therapeutic use
  • Humans
  • Macular Degeneration / chemically induced*
  • Meta-Analysis as Topic
  • Prospective Studies
  • Randomized Controlled Trials as Topic
  • Risk Factors

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Fibrinolytic Agents
  • Aspirin