To review current literature of the benefits that aspirin provides for patients' cardiovascular health compared with the risk of AMD worsening.
We performed a review and critically analyzed six cardiovascular and four ophthalmological trials regarding risks and benefits of aspirin use. The prospective randomized cardiovascular trials had a cumulative 167,580 while the 3 smaller ophthalmological data sets had a cumulative 12,015 subjects.
The reviewed meta-analysis literature demonstrated a statistically significant 32% reduction in the risk of nonfatal stroke with regular aspirin users. The study also documented that aspirin users decreased the risk of fatal vascular deaths by 15%. Of the three ophthalmological studies highlighting the adverse affects of aspirin association with AMD, all suggested an exacerbation of AMD without statistical significance and broad confidence bands.
Overall, the number, size, and quality of the cardiovascular studies recommending aspirin use are far superior to the fewer, smaller and conflicting studies suggesting a possible adverse effect of aspirin use in relation to AMD. The benefits of aspirin usage include preserving the duration and quality of life by decreasing stroke and heart attack risk. These benefits seem to far outweigh the theoretical risks of possibly exacerbating wet AMD, which can be reasonably controlled with anti-VEGF therapy.
The purpose of this paper is to inform physicians and patients that the quality and quantity of the data regarding the cardiovascular benefits of aspirin far exceed the data of the theoretical risk of aspirin in possibly exacerbating age-related macular degeneration (AMD). Patients should continue aspirin use prescribed by their doctor without concern.
*Macula and Retina Institute, Los Angeles and Glendale, California and
†Molecular Insight Research Foundation, Los Angeles and Glendale, California.
Reprint requests: Kent W. Small, MD, Macula and Retina Institute, 501 North Orange Street, Glendale, CA 91203; e-mail: firstname.lastname@example.org.
None of the authors has any financial/conflicting interests to disclose.