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Author Spotlight: Understanding Age-Related Macular Degeneration Pathophysiology with QAF Workflow
Published on: May 26, 2023
MACULAR DEGENERATION AND ASPIRIN USE
Kent W Small1, Christine A Garabetian, Fadi S Shaya
1*Macula and Retina Institute, Los Angeles and Glendale, California and †Molecular Insight Research Foundation, Los Angeles and Glendale, California.
Insights
Aspirin significantly reduces stroke and vascular death risks. While some studies suggest a possible link to worsening age-related macular degeneration (AMD), the cardiovascular benefits of aspirin outweigh these potential risks.
Area of Science:
- Cardiology
- Ophthalmology
- Pharmacology
Background:
- Aspirin is widely used for cardiovascular disease prevention.
- Age-related macular degeneration (AMD) is a leading cause of vision loss in older adults.
Purpose of the Study:
- To evaluate the cardiovascular benefits of aspirin.
- To assess the risk of aspirin use exacerbating age-related macular degeneration (AMD).
Main Methods:
- A systematic review and meta-analysis of six cardiovascular trials (167,580 participants) and four ophthalmological studies (12,015 participants).
- Critical analysis of prospective randomized trials and ophthalmological data sets.
Main Results:
- Aspirin use was associated with a 32% reduction in nonfatal stroke risk and a 15% reduction in fatal vascular deaths.
- Ophthalmological studies indicated a potential, but not statistically significant, exacerbation of AMD with aspirin use.
Conclusions:
- The substantial cardiovascular benefits of aspirin, including reduced stroke and heart attack risk, outweigh the theoretical risks of AMD exacerbation.
- Current evidence suggests aspirin is beneficial for cardiovascular health, with potential AMD risks manageable through therapies like anti-VEGF.
Purpose:
To review current literature of the benefits that aspirin provides for patients' cardiovascular health compared with the risk of AMD worsening.
Methods:
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.
Results:
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.
Conclusion:
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.
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