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Long-term use of aspirin and age-related macular degeneration.
JAMA 2012; 308(23):2469-78JAMA

Abstract

CONTEXT

Aspirin is widely used for relief of pain and for cardioprotective effects. Its use is of concern to ophthalmologists when ocular surgery is being considered and also in the presence of age-related macular degeneration (AMD).

OBJECTIVE

To examine the association of regular aspirin use with incidence of AMD.

DESIGN, SETTING, AND PARTICIPANTS

The Beaver Dam Eye Study, a longitudinal population-based study of age-related eye diseases conducted in Wisconsin. Examinations were performed every 5 years over a 20-year period (1988-1990 through 2008-2010). Study participants (N = 4926) were aged 43 to 86 years at the baseline examination. At subsequent examinations, participants were asked if they had regularly used aspirin at least twice a week for more than 3 months.

MAIN OUTCOME MEASURE

Incidence of early AMD, late AMD, and 2 subtypes of late AMD (neovascular AMD and pure geographic atrophy), assessed in retinal photographs according to the Wisconsin Age-Related Maculopathy Grading System.

RESULTS

The mean duration of follow-up was 14.8 years. There were 512 incident cases of early AMD (of 6243 person-visits at risk) and 117 incident cases of late AMD (of 8621 person-visits at risk) over the course of the study. Regular aspirin use 10 years prior to retinal examination was associated with late AMD (hazard ratio [HR], 1.63 [95% CI, 1.01-2.63]; P = .05), with estimated incidence of 1.76% (95% CI, 1.17%-2.64%) in regular users and 1.03% (95% CI, 0.70%-1.51%) in nonusers. For subtypes of late AMD, regular aspirin use 10 years prior to retinal examination was significantly associated with neovascular AMD (HR, 2.20 [95% CI, 1.20-4.15]; P = .01) but not pure geographic atrophy (HR, 0.66 [95% CI, 0.25-1.95]; P = .45). Aspirin use 5 years (HR, 0.86 [95% CI, 0.71-1.05]; P = .13) or 10 years (HR, 0.86 [95% CI, 0.65-1.13]; P = .28) prior to retinal examination was not associated with incident early AMD.

CONCLUSIONS

Among an adult cohort, aspirin use 5 years prior to observed incidence was not associated with incident early or late AMD. However, regular aspirin use 10 years prior was associated with a small but statistically significant increase in the risk of incident late and neovascular AMD.

Authors+Show Affiliations

Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison 53726-2336, USA. kleinb@epi.ophth.wisc.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23288416

Citation

Klein, Barbara E K., et al. "Long-term Use of Aspirin and Age-related Macular Degeneration." JAMA, vol. 308, no. 23, 2012, pp. 2469-78.
Klein BE, Howard KP, Gangnon RE, et al. Long-term use of aspirin and age-related macular degeneration. JAMA. 2012;308(23):2469-78.
Klein, B. E., Howard, K. P., Gangnon, R. E., Dreyer, J. O., Lee, K. E., & Klein, R. (2012). Long-term use of aspirin and age-related macular degeneration. JAMA, 308(23), pp. 2469-78. doi:10.1001/jama.2012.65406.
Klein BE, et al. Long-term Use of Aspirin and Age-related Macular Degeneration. JAMA. 2012 Dec 19;308(23):2469-78. PubMed PMID: 23288416.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term use of aspirin and age-related macular degeneration. AU - Klein,Barbara E K, AU - Howard,Kerri P, AU - Gangnon,Ronald E, AU - Dreyer,Jennifer O, AU - Lee,Kristine E, AU - Klein,Ronald, PY - 2013/1/5/entrez PY - 2013/1/5/pubmed PY - 2013/1/19/medline SP - 2469 EP - 78 JF - JAMA JO - JAMA VL - 308 IS - 23 N2 - CONTEXT: Aspirin is widely used for relief of pain and for cardioprotective effects. Its use is of concern to ophthalmologists when ocular surgery is being considered and also in the presence of age-related macular degeneration (AMD). OBJECTIVE: To examine the association of regular aspirin use with incidence of AMD. DESIGN, SETTING, AND PARTICIPANTS: The Beaver Dam Eye Study, a longitudinal population-based study of age-related eye diseases conducted in Wisconsin. Examinations were performed every 5 years over a 20-year period (1988-1990 through 2008-2010). Study participants (N = 4926) were aged 43 to 86 years at the baseline examination. At subsequent examinations, participants were asked if they had regularly used aspirin at least twice a week for more than 3 months. MAIN OUTCOME MEASURE: Incidence of early AMD, late AMD, and 2 subtypes of late AMD (neovascular AMD and pure geographic atrophy), assessed in retinal photographs according to the Wisconsin Age-Related Maculopathy Grading System. RESULTS: The mean duration of follow-up was 14.8 years. There were 512 incident cases of early AMD (of 6243 person-visits at risk) and 117 incident cases of late AMD (of 8621 person-visits at risk) over the course of the study. Regular aspirin use 10 years prior to retinal examination was associated with late AMD (hazard ratio [HR], 1.63 [95% CI, 1.01-2.63]; P = .05), with estimated incidence of 1.76% (95% CI, 1.17%-2.64%) in regular users and 1.03% (95% CI, 0.70%-1.51%) in nonusers. For subtypes of late AMD, regular aspirin use 10 years prior to retinal examination was significantly associated with neovascular AMD (HR, 2.20 [95% CI, 1.20-4.15]; P = .01) but not pure geographic atrophy (HR, 0.66 [95% CI, 0.25-1.95]; P = .45). Aspirin use 5 years (HR, 0.86 [95% CI, 0.71-1.05]; P = .13) or 10 years (HR, 0.86 [95% CI, 0.65-1.13]; P = .28) prior to retinal examination was not associated with incident early AMD. CONCLUSIONS: Among an adult cohort, aspirin use 5 years prior to observed incidence was not associated with incident early or late AMD. However, regular aspirin use 10 years prior was associated with a small but statistically significant increase in the risk of incident late and neovascular AMD. SN - 1538-3598 UR - https://www.unboundmedicine.com/medline/citation/23288416/Long_term_use_of_aspirin_and_age_related_macular_degeneration_ L2 - https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2012.65406 DB - PRIME DP - Unbound Medicine ER -