Blog post by: Eye Physicians of Long Beach

Reconciling the benefits of taking aspirin (ASA) with the possible side effects leaves many seniors unsure whether they should continue doctor recommended aspirin therapy. Daily aspirin can significantly reduce the risk of heart attack and stroke, especially for those who already have experienced symptoms of heart disease. These patients are often placed on a low dose aspirin therapy with impressive results. As with most medications, there are side effects of taking aspirin. One that may be important for seniors is the possibility of an increased risk of age-related macular degeneration (AMD), which is the leading cause of blindness in adults over age 60. Let’s discuss the risks factors leading to AMD and what we know of the effect of ASA and AMD.

The main risk factors for AMD are age, race, genetic factors and cigarette smoking. More recently aspirin usage has been implicated as a risk factor.

It is important to note that research on the link between macular degeneration and aspirin are far from conclusive. Concerns regarding aspirin therapy in seniors find its source in a 2013 study that demonstrated a link between daily aspirin and increased occurrence of macular degeneration. The Beaver Dam Eye Study reported a two-fold increased in the incidence of late macular degeneration in long-term aspirin users compared to patients that did not take aspirin. The disconcerting study by Blue Mountain Eye may have shown an increased risk of macular degeneration with aspirin patients, but it did not account for other risk factors that may have been the true cause of the correlation. In addition, various other scientific studies have not been able to establish this link. In fact, two prior studies have found no relationship and one suggested that there was a lower risk of macular degeneration in Aspirin users.

One of the theories about the mechanism through which aspirin contributes to AMD is that it may activate the complement portion of the immune system and as a result, the immune system can become chronically overstimulated and that it is the immune system that causes damage. Vitamin and mineral supplementation as per the AREDS and AREDS 2 trials may slow the progression of AMD.

It is important for seniors who are concerned about their aspirin therapy to discuss any changes with their primary care physician before discontinuing treatment. While it is natural to be concerned about eye health, it is essential to discuss medication changes with your doctor to determine overall risks and benefits.

With various studies resulting in opposing answers to the question of a link between aspirin and macular degeneration, research will continue to provide insight into the best care and advice to patients. With the objective of optimal health and well-being, studies of macular degeneration and its causes continue to seek definitive answers.

While researchers continue to study the effects of aspirin therapy on macular degeneration, one thing is certain. The cardiovascular benefits of daily low dose aspirin for certain adults are significant and life-saving. While ophthalmologists are uncertain about aspirin’s effect on a patient’s risk of macular degeneration, they are certain that it reduces the risk of heart attack and stroke, which are both leading causes of death in seniors. For this reason, patients are encouraged to continue taking their aspirin until hard evidence can demonstrate they would be better off otherwise.

There may not be a direct link between aspirin and macular degeneration, but it does make sense that the patients with cardiovascular disease also have eye problems. General poor health and advanced age are leading factors leading to macular degeneration. Therefore, it may simply be this correlation that links AMD and aspirin. The health and lifestyle factors that lead to heart disease may also increase the risk of macular degeneration. With the benefits of aspirin proven and the risk not established, seniors should continue with aspirin therapy.