Risk of age‐related macular degeneration in aspirin users and non‐aspirin users: A population‐based cohort study in Taiwan

Abstract

BackgroundThe association between cardioprotective aspirin and risk of age‐related macular degeneration (AMD) is still controversial up to date. We aimed to analyze the risk of AMD between aspirin users and non‐aspirin users.MethodThis was a retrospective cohort study by using claims data from the National Health Insurance Research Database. Patients aged more than 45 years old who initiated aspirin during 2002 to 2012 were followed till 2013. We first selected an age and sex‐matched cohort, then identified aspirin users and non‐aspirin users as propensity score‐matched cohort. Cox proportional hazard regression model was applied to compare their hazards and 95% confidence intervals. Incidence of newly developed AMD, neovascular AMD, and other‐AMD was calculated.ResultsWe identified 204 085 regular aspirin users and 478 048 non‐aspirin users from our datasets. The univariate HR was 2.85 (95% CI, 2.75‐2.96), and the multivariate HR was 2.54 (95% CI, 2.44‐2.65). In the PS‐matched cohort, the HR was 2.38 (95% CI, 2.25‐2.52). The incidence of aspirin users for AMD risk was 11.95 per 1000 person‐year, while the incidence of non‐aspirin users was only 3.92 per 1000 person‐year.ConclusionPatients with regular use of aspirin had higher risk in developing AMD compared to non‐aspirin users and suggest to have regular visual acuity and funduscopic examination.

Association of lipid-lowering drugs and antidiabetic drugs with age-related macular degeneration: a meta-analysis in Europeans

“…[18] In contrast, results from a randomized controlled trial (RCT) did not show an effect of ASA use on progression to late AMD [17]. Particularly ASA, which is part of the group of NSAID and anti-thrombotic drugs has been subject to various inhomogeneous studies and has even been reported to increase the risk of AMD [68,69]. Yet, OTC drugs are often used as needed and not regularly and as such may underlie a recall bias more than frequently used drugs.…”

Effect of Low-Dose Aspirin on the Course of Age-Related Macular Degeneration

“…Both studies relied on self-reported aspirin use and AMD status identified from hospital discharge records. Other observational studies have either reported no benefit from aspirin or have reported harm, with a particular concern regarding the potential for an increased risk of bleeding among those at higher risk of nAMD …”

Association Between Aspirin Usage and Age-Related Macular Degeneration: An Updated Systematic Review and Meta-analysis

“…However, the results on the association between aspirin and AMD were controversial. A previous study conducted by Lee et al (Lee et al, 2021) reported that patients with regular use of aspirin had a higher risk of developing AMD compared to nonaspirin users. However, another study denied this association (Rim et al, 2019).…”

“…Based on the above inclusion and exclusion criteria, 1,661 abstracts and titles were reviewed initially. After retrieving 46 full-length manuscripts, 16 articles (Blumenkranz et al, 1986;Christen et al, 2001;Klein et al, 2001;DeAngelis et al, 2004;Clemons et al, 2005;Douglas et al, 2007;Christen et al, 2009;Rudnicka et al, 2010;de Jong et al, 2012;Klein et al, 2012;Cheung et al, 2013;Liew et al, 2013;Modjtahedi et al, 2018;Keenan et al, 2019;Rim et al, 2019;Lee et al, 2021) were included for data extraction and meta-analysis.…”

“…The sample size ranged from 49 to 682133 AMD Patients. The eight included studies were conducted in the United States (Blumenkranz et al, 1986;Christen et al, 2001;Klein et al, 2001;DeAngelis et al, 2004;Clemons et al, 2005;Christen et al, 2009;Klein et al, 2012;Modjtahedi et al, 2018), one each in UK (Rudnicka et al, 2010), China (Lee et al, 2021), Singapore (Cheung et al, 2013), South Korea (Rim et al, 2019), and Australia (Liew et al, 2013), and one each in seven European countries (de Jong et al, 2012) including Bergen (Norway), Tallinn (Estonia), Belfast (UK), Paris-Creteil (France), Verona (Italy), Thessaloniki (Greece), and Alicante (Spain). Among the studies, five were casecontrol, two were RCTs, six were cohorts, and three were cross-sectional studies.…”