The Role of Aspirin in Age-related Macular Degeneration: the ASPREE-AMD Randomized Controlled Trial

Abstract

Purpose : To describe the baseline characteristics of the participants of the ASPREE-AMD trial, which aims to investigate the effect of long-term low dose of aspirin intake on the course of age-related macular degeneration (AMD).

Methods : Australians from the ASPirin in Reducing Events in the Elderly (ASPREE) trial, aged 70 years or older, with no overt cardiovascular disease or significant physical disability, were randomized to daily 100 mg aspirin or placebo for 5 years of follow up. They underwent non-mydriatic, 45°, digital colour fundus photography at study centres or in mobile units. Images were graded for AMD according to the Beckman classification. Non-ocular measures were collected in the course of the principal ASPREE trial.

Results : In total, 5044/5418 (93.2%) of the photographed ASPREE participants with gradable macular images were enrolled into ASPREE-AMD sub-study, with 48% female, 98% white Caucasians , 10% with diabetes, 73% with hypertension, 44% being former or current smokers, 29% with BMI of ≥30 kg/m². Education less than12 years had 44%, from 12 to 15 years - 28% and 16 or more years - 28% of the participants.
In 675/5044 (13.4%) of the ASPREE-AMD participants, confounding pathology (n=10), low image quality (n=611) and no photo from one eye (n=53) resulted images being graded in one eye only.
Early AMD was detected in 1,047 (20.8%), intermediate AMD in 814 (16.1%) and late AMD in 60 (1.2%) cases, with 22 of the latter being bilateral. In the age groups of 70-74 years (n=3245), 75-79 years (n=1216), 80-84 years (n=452) and 85years or older (n=131), early AMD was detected in 20%, 23%, 22% and 15%; intermediate AMD in 14%, 18%, 22% and 31%, and late AMD in 0.6%, 1.6%, 3.5% and 4.6% of participants, respectively.

Conclusions : Capitalizing on the ongoing large-scale primary prevention randomized clinical trial (ASPREE) presents sufficient sample size and a unique opportunity to determine the effect of long-term low-dose intake of aspirin on the course of AMD.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.