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Christine Garabetian, Kent W Small, Fadi Shaya; Benefits of Aspirin Outweigh Risks in Age-related Macular Degeneration Patients. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3200. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
Recent press releases regarding the potential adverse effects of aspirin on macular degeneration have caused patients with Age-related Macular Degeneration (AMD) to discontinue their aspirin use without consulting their physician. We compared current literature, including meta-analyses, of small, epidemiological AMD studies to large, randomized, placebo-controlled cardiovascular studies, in order to weight the benefits that aspirin provides for patients’ cardiovascular health compared to the risk of AMD worsening.
Nine cardiovascular and ten ophthalmological studies were reviewed and analyzed for risks/benefits of aspirin use. The three retrospective epidemiological eye studies (n=12,105) suggesting harmful effects of aspirin use for individuals with AMD were compared to the randomized, placebo-controlled cardiovascular studies (n=167,580) and meta-analyses for each group were reviewed. Confidence intervals, study size, and odds ratios were calculated using t-tests and online calculators for each study type and the information was graphed. Limitations regarding the epidemiological eye studies and the cardiovascular studies were thoroughly addressed.
The reviewed meta-analysis literature demonstrated a statistically significant 32% reduction in the risk of non-fatal stroke with regular aspirin users. The study also documented that aspirin users decreased the risk of fatal vascular deaths by 15%. The three ophthalmological studies highlighting the suggested aspirin exacerbation of AMD contain statistical insignificance and have vast limitations in their findings. The confidence intervals for all tree studies consist of broad bands (BMES: 1.25-4.83 and BDES: 1.20-4.15) when compared to the cardiovascular randomized placebo-controlled studies (Physician’s Health Study: 0.656-0.900; Women’s Health Study: 0.804-1.034).
Overall the number, size, and quality of the cardiovascular studies recommending aspirin use is far superior to the fewer, smaller and conflicting studies suggesting a possible exacerbation of aspirin on AMD. The small and still unconfirmed added risk of AMD is far outweighed by the solid benefits of cardio-protective aspirin. The ophthalmological studies cannot conclude for certain if aspirin causes late-life vision loss. Patients who are taking aspirin for cardiovascular health should not fear the possible, theoretical and exaggerated risks of exacerbating their AMD.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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