Aspirin Use Linked to Aging Macula Disorder in Older Individuals

May 4, 2010 (Fort Lauderdale, Florida) — People 65 years and older who frequently take aspirin have an increased risk of developing aging macula disorder — a loss of central vision similar to age-related macular degeneration — according to a population-based, cross-sectional study presented here at the Association for Research in Vision and Ophthalmology 2010 Annual Meeting.

"There have been several studies that have found an association between aspirin use and aging macula disorder, and several studies that have found no association between the 2," Paulus de Jong, MD, PhD, from Ophthalmogenetics, NIN/Genetics, in Amsterdam, the Netherlands, said. "We wanted to disentangle the conflicting evidence with this study."

The European Eye (EUREYE) study of 4691 patients 65 years and older was conducted in 7 centers in Northern and Southern Europe. The subjects were asked, in a structured questionnaire, about their use of aspirin and about possible risk factors for aging macula disorder.

Possible confounding factors included age, systolic blood pressure, cholesterol level, sex, history of alcohol consumption, angina, cardiovascular disease, diabetes mellitus, education level, intake of other pain killers, and smoking.

In all, 36.4% of the study subjects had early aging macula disorder, and 3.3% had late aging macula disorder.

Forty-one percent of participants reported monthly use of any aspirin, 7% reported use of aspirin at least once a week, and 17.3% said they used aspirin every day.

Dr. de Jong reported that the odds ratios for grade 1 early aging macula disorder rose with increasing aspirin intake frequency, and reached 1.26 (95% confidence interval [CI]. 1.08 - 1.46; P trend < .001) for subjects who reported daily use.

Similarly, the odds ratio for grade 2 early aging macula disorder was 1.40 (95% CI, 1.16 - 1.68; P trend < .001) in daily aspirin users; for neovascular aging macula disorder, the odds ratio was 2.26 (95% CI, 1.66 - 3.08; P trend < .001) in daily aspirin users.

This association was maintained after adjustment for all potential confounding factors, including cardiovascular disease, he noted.

Dr. de Jong pointed out that the study was cross-sectional and no details about the actual amount of aspirin were obtained. In addition, there might have been some recall bias, with some subjects confusing aspirin with other analgesics, he said.

Nevertheless, he concluded, "frequent aspirin use seems to be harmful for aging macula disorder in older populations. Future case–control studies, cohort studies, or randomized trials might be able to determine the magnitude of these associations.

In an interview with Medscape Ophthalmology, Dr. de Jong said that, despite these results, "patients should not stop taking their aspirin if they are taking it for cardiovascular disease. But if they are taking it as a pain killer, there are other medications they can use."

Emily Chew, MD, from the National Eye Institute and the National Institutes of Health in Bethesda, Maryland, who comoderated the session at which Dr. de Jong spoke, told Medscape Ophthalmology that the findings were "interesting," but added that the study, because it is observational, can only point to an association between aging macula disorder and aspirin.

"We don't know why the patients were taking aspirin. Was it because they had arthritis? Did they have cardiovascular disease? We really know very little about these patients. Also, the Women's Health Study, which was a randomized controlled trial, showed no link between aspirin and aging macula disorder. So it is possible that there is some association, but more studies need to be done to explore this."

Dr. de Jong and Dr. Chew have disclosed no relevant financial relationships.

Association for Research in Vision and Ophthalmology (ARVO) 2010 Annual Meeting: Abstract 1620. Presented May 3, 2010.