Daily aspirin tied to risk of vision loss
Seniors who take aspirin daily are twice as likely to have late stage macular degeneration, an age-related loss of vision, than people who never take the pain reliever, a new European study reports.
The data do not show that aspirin causes vision loss. But the findings are of concern if aspirin somehow exacerbates the eye disorder, researchers say, given how many seniors take it daily for heart disease.
“For people who have age-related macular degeneration, it probably isn’t wise to recommend taking aspirin,” said William Christen of Brigham and Women’s Hospital in Boston, who was not involved in this study.
Researchers led by Dr. Paulus de Jong at the Netherlands Institute for Neuroscience and Academic Medical Center collected health and lifestyle information from nearly 4,700 people over age 65.
The study, published in the journal Ophthalmology, included Norwegian, Estonian, British, French, Italian, Greek and Spanish seniors.
Of the 839 people who took aspirin each day, 36 had an advanced form of the disease called wet macular degeneration.
Is Aspirin Contributing to the Increase in Macular Degeneration?
Macular degeneration is becoming a serious problem in the United States; it is the leading cause of blindness in people over 55. In 2004, it was estimated that 1.75 million U.S. residents had significant symptoms associated with age-related macular degeneration. Since then, expert estimates are that anywhere from 3 to 7.5 million individuals will suffer significant vision loss as a result of macular degeneration by 2020.
For those on a daily aspirin regimen per their doctor’s instructions, the estimates are even higher. According to optometrist and licensed acupuncturist Dr. Marc Grossman, some studies have shown that aspirin is actually responsible for some cases of macular degeneration in that it caused retinal hemorrhages.
Doctors generally prescribe aspirin because it thins the blood, which keeps it flowing and prevents blood clots from forming. This is a good idea, but when it comes to macular degeneration, there are safer and better ways to thin the blood that will not affect a person’s vision.
This equates to about four out of every 100 daily aspirin users.
In comparison, roughly two out of every 100 people who took aspirin less frequently had the same type of macular degeneration.
The wet form of the eye condition, caused by leaking blood vessels in the eye, leads to vision loss in the center of the eye’s field of vision.
The dry form of macular degeneration is more common and less severe, although people still suffer visual impairment.
Together, wet and dry macular degeneration make up the leading causes of vision loss among people over age 60, afflicting millions of Americans.
The researchers found that aspirin use was not tied to the dry form, nor to earlier stages of the disease.
“I don’t think that’s surprising,” Christen told Reuters Health. “I think the effects of aspirin may be different in the early stages of age-related macular degeneration than in the late stages.”
Aspirin is often taken to prevent cardiovascular disease, and Paulus told Reuters Health there has been controversy over the link between cardiovascular disease and macular degeneration.
Paulus wrote in an email that his team “analyzed as meticulously as possible” whether cardiovascular disease might have influenced the results, and still found that aspirin users - regardless of their heart health - are at a greater risk of the more serious type of vision loss.
While it’s a good idea to caution people that aspirin might have a deleterious role in macular degeneration, “a healthy eye with full visual capacities is of no use in a dead body,” Paulus said.
In other words, for people with cardiovascular disease who take aspirin to prevent the condition from worsening, the benefits of the drug outweigh the risks to visual health.
Paulus said larger studies that follow people over time and document their aspirin use and vision will help resolve aspirin’s role in macular degeneration.
SOURCE: Ophthalmology, online September 13, 2011.