Associations Between Aspirin Use and Aging Macula Disorder. The Eureye Study

Abstract

Purpose: : To disentangle the conflicting evidence on associations between aspirin use and aging macula disorder (AMD), similar to age-related macular degeneration.

Methods: : Population-based, cross-sectional EUREYE study in seven centers from North to South Europe. Intake of any dose of aspirin and possible risk factors for AMD were ascertained by a structured questionnaire. Ophthalmic and basic systemic measurements were performed in a standardized way. Early AMD, subdivided in grades 1-3, and late AMD, subdivided as neovascular AMD or geographic atrophy, were graded on digitized fundus images by experienced graders in one center. Associations were analyzed by logistic regression with adjustment for potential confounders as age, systolic blood pressure, BMI, cholesterol level, sex, and history of alcohol consumption, angina, cardiovascular disease (CVD), diabetes mellitus, education level, intake of other pain killers, and smoking.

Results: : Of 4691 participants aged 65 or over, 36.4% had early AMD and 3.3% late AMD. Monthly use of any aspirin was reported by 41.2%, at least once a week by 7% and daily use by 17.3%. Odds ratios for grade 1 early AMD rose with increasing aspirin intake frequency till 1.26 (95% confidence interval (CI) 1.08-1.46; p trend < 0.001) for daily users; similarly for grade 2 early AMD till 1.40 (95%CI 1.16-1.68; p trend < 0.001) and for neovascular AMD till 2.26 (95%CI 1.66-3.08; p trend < 0.001) after full adjustment, including for CVD. There was no interaction between aspirin use and angina or CVD. No association was found with geographic atrophy.

Conclusions: : Frequent aspirin use seems to be harmful for AMD in older populations. Future case-control studies, cohort studies or randomized trials might further elucidate the magnitude of these associations.

Keywords: age-related macular degeneration • drug toxicity/drug effects