Age-related macular degeneration (AMD) is a major public health problem because it causes blindness and the high cost associated with current treatments to combat it.
Taking into account how widespread the use of low-dose aspirin has been and the possibility that it is a risk for the development of neovascular AMD, it is necessary to investigate this important public health problem in a large cohort.
South Korea has a single National Health Insurance, which is a good source of information to compare the incidence of neovascular AMD between patients who regularly consume aspirin and patients who do not.
| Patients and methods |
Regular and non-regular aspirin consumers within the national health insurance, over 45 years of age, participated between 2010 and 2015.
The incidence per 10,000 people of neovascular AMD was estimated. Long-term regular use of low-dose aspirin was defined as sustained aspirin use of less than 100 mg for more than 1044 days between 2005 and 2009.
Non-regular consumers are considered occasional consumers or non-consumers. Statistical analysis was performed to obtain the propensity index. The incidence of development of new cases of AMD was searched in the national health insurance database.
In the present study, the incidence of new cases of AMD developing among non-regular and regular aspirin users was estimated.
The incidence was higher among regular users (7.2 per 10,000 people/year) than among non-regular users (3.5 per 10,000 people/year). According to the statistical analyzes performed, we did not find any significant association between long-term use of low-dose aspirin and increased risk of neovascular AMD.
There are two other important studies that investigated this association. In the Beaver Dam study, they found an association between aspirin consumption and increased risk of neovascular AMD. However, the definition of regular users may not reflect regular aspirin consumption since the cumulative dose was a minimum of only 24 tablets.
The second study is the Blue Mountain study and showed that regular aspirin users were much older and more likely to have other pathologies. Regular users were more likely to have neovascular AMD than non-users.
However, the number of cases was small, few variables were taken into account, and information was lacking. In the present study, the number of participants is more important and the analyzes performed are more sophisticated, based on propensity indices.
In the present study, regular aspirin users were older than non-regular users. Age is the most important risk factor for neovascular AMD. These results from South Korea may not generalize to other ethnic groups.
In summary, our propensity score-matched and maximally adjusted analyzes demonstrated no association between long-term regular use of low-dose aspirin and the incidence of neovascular AMD.
This practical verification using a representative sample of the national population indicates that aspirin is safe with respect to the development of neovascular AMD.
