A research study of over 2,000 Australian subjects followed for 15 years has shown that regular use of aspirin doubled the likelihood of developing the wet form of age related macular degeneration compared to non-use..  Another study of a European population also found that people over 65 who took aspirin daily had double the risk of developing wet macular degeneration.  These studies do not prove that regular use of aspirin actually causes macular degeneration, only that there seems to be a correlation between regular aspirin use and development of macular degeneration later in life.
Paulus T. V. M. de Jong, MD, PhD, of the Netherlands Institute for Neuroscience and Academic Medicine lead the European Study of over 4,000 subjects.  The Australian study was headed by Gerald Liew, Ph.D. from the Centre for Vision Research Westmead Millennium Institute for Medical Research in Sydney, Australia.
Regular use of aspirin has been a standard of treatment for people with cardiovascular disease to prevent further worsening.  Age related macular degeneration is a leading cause of loss of vision for people over 60 years old.   Both are diseases that present in older people.  People who have heart disease are more likely to use aspirin daily than people who use it only occasionally.  Aspirin use has not been found to contribute to the dry form of macular degeneration, only with the wet form where small blood vessels form under the retina and their leakage causes blindness to develop.  One theory posits that a particular gene found in some people with wet macular degeneration may be involved triggering an over stimulated response of the immune system thus causing damage in the back of the eye.
While the regular use of aspirin does increase the risk of developing macular degeneration, the risk for people with cardiovascular disease is less than the risk of heart failure.  Dr. de Jong, the author of the European study, said the benefits of aspirin outweigh the risks to visual health:  “A healthy eye with full visual capacities is of no use in a dead body.”  He also commented that larger studies done over longer periods of time are necessary to help understand the relationship between aspirin and macular degeneration.
The Association of Aspirin Use With Age-Related Macular Degeneration; Gerald Liew, PhD; Paul Mitchell, PhD; Tien Yin Wong, PhD; Elena Rochtchina, MAppStat; Jie Jin Wang, PhD;JAMA Intern Med. 2013 Feb 25;173(4):258-64. doi: 10.1001/jamainternmed.2013.1583.
 
De Jong PTVM, et al “Associations between aspirin use and aging macula disorder: The European eye study” Ophthalmology 2012; DOI: 10.1016/j.ophtha.2011.06.025.

Review by Marcia McCall

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