Aspirin and the risk of Wet AMD

Commentary: Patients are quite informed nowadays, I was asked about the news of aspirin and the increased risk of wet AMD. There are contradicting results among studies of the association of aspirin and AMD.

Just use common sense, there is a reason that the medical doctors recommend those patients to take aspirin for their cardiovascular diseases (cardiac attacks, TIA or strokes) in the studies. As wet AMD is a disease that the underneath layer of the macula (the choroid layer) grows abnormal new vessels, which will either leak fluid or bleed out. The increased risk of cardiovascular diseases and wet AMD has been linked in some studies. Therefore, it may be normal to find more wet AMD in aspirin users than aspirin non-users.

The first motto of medical profession is “do no harm”; if your medical doctors recommend you to be on aspirin to prevent cardiovascular events (strokes or heart attacks), then keep using them. Saving lives comes first before saving sights.


A study has found that regularly taking aspirin increases the risk of neovascular age-related macular degeneration (AMD).

The study, led by Barbara E. K. Klein, MD, MPH, of the University of Wisconsin School of Medicine and Public Health, analyzed data from the Beaver Dam Eye Study, a longitudinal population-based study of age-related eye diseases conducted in Wisconsin.


Nearly 5,000 people participated at the baseline examination, ranging in age from 43 to 86. Examinations were performed every five years over 20 years, and participants were asked if they had regularly used aspirin at least twice a week for more than three months. The average duration of follow-up was 14.8 years.

Over the course of the study, there were 512 cases of early AMD and 117 cases of late-stage AMD.

The researchers found that regular aspirin use 10 years before the retinal examination was associated with late AMD (1.8 percent for aspirin users and 1.0 percent for non-users).

One subtype of late AMD, neovascular AMD, had a significant association with aspirin use: 1.4 percent of aspirin users had neovascular AMD compared with 0.6 percent for non-users.

There was no significant association for early AMD or geographic atrophy, the other subtype of late AMD.

“Our findings are consistent with a small but statistically significant association between regular aspirin use and incidence of neovascular AMD,” the research authors concluded.

Previous studies of aspirin use and AMD have yielded inconsistent results. In fact, the results of the Klein et al. study contradict the recent findings of Emily Y. Chew, MD, deputy director of the Division of Epidemiology and Clinical Applications, National Eye Institute.

Speaking at the 2012 annual meeting of the American Academy of Ophthalmology in November, Dr. Chew presented data from AREDS (Age-Related Eye Disease Study) and the follow-up study, AREDS2, which found that aspirin use did not increase the risk of developing AMD.

However, if further studies confirm the Beaver Dam Eye Study findings led by Dr. Klein, developing ways to slow the effect, especially for people who use aspirin to help prevent cardiovascular disease, will be of particular importance in the study and treatment of neovascular AMD.

The Klein et al. study was published in the Journal of the American Medical Association in December 2012.

Source All About Vision

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