Does acetylsalicylic acid favors eye disease?

Acetylsalicylic acid (ASA) may promote age-related macular degeneration

20.12.2012

Now, a US study shows that drugs are not only beneficial but also dangerous. Thus, the regular intake of acetylsalicylic acid (ASA) could promote the development of a wet form of age-related macular degeneration (AMD). At the beginning of the year, a Dutch study came to a similar conclusion.

Acetylsalicylic acid leads to an increased risk of AMD
In wet or neovascular age-related macular degeneration (AMD), the formation of pathological blood vessels in the macula results in rapid loss of vision in the area of ​​sharpest vision. Eye disease is the leading cause of blindness in old age.

Paulus de Jong of the Dutch Institute of Neuroscience in Amsterdam, at the beginning of the year, found a link between the regular intake of acetylsalicylic acid (ASA) and this disease as part of an analysis of the European Eye Study. For the investigation, the data of 4,600 senior citizens in the period from 2000 to 2003 were collected and evaluated. As it turned out, one in three suffered from the dry form of AMD and about one in 30 from wet AMD. The latter were twice as likely as the others to take ASA. After taking into account the gender, age and other cardiovascular risks associated with AMD, De Jong concluded that patients taking ASA suffer twice as often as other people.

Second study also sees acetylsalicylic acid and eye disease together
Barbara Klein from the University of Wisconsin and her team re-examined the relationship between the drug and eye disease. As part of the Beaver Dam Eye Study since 6,000 inhabitants of a small town since 1987 regularly examined ophthalmology. The study participants also provided information about their life habits. Subsequently, an analysis of the data of 4,926 participants was performed, which showed no signs of AMD at the beginning of the study.

It turned out that in the following 14.8 years 117 persons fell ill with a late and 512 with an early form of AMS. The US researchers came to a similar result as de Jong: only in patients with late AMD (subtype: wet AMD) could be associated with the association with AS, as Klein and her colleagues in the „Journal of the American Medical Association“ to report.

Acetylsalicylic acid is not the cause of eye disease
According to experts, the evidential value of the Dam Eye Study is higher than that of the European Eye Study, as the study participants were prospectively monitored over a longer period of time. The analysis of the European Eye Study is based only on a cross-sectional study, it is said in the Deutsches Ärzteblatt. But even the American study owes a proof. Most patients have taken ASA to prevent cardiovascular disease. It is likely that many are secondary prevention after a first event. However, cardiovascular disease is a risk factor for AMD. Thus, ASA can not be the cause of AMD but just another marker of increased risk of eye disease.

Treatment options of wet AMD
The wet form of AMD leads to rapid vision loss as pathological blood vessels sprout into the macula. Ophthalmologists are therefore trying to repress the vessels by administering intravitreal surgical drugs (IVOM) or by laser treatment or photodynamic therapy to stop the disease from progressing. Lost eyesight can only partially or completely be restored in some cases. This requires early therapy with injections of vascular growth inhibitors (Anti-VEGFs, Anti-Vascular Endothelial Growth Factor) into the vitreous humor (IVOM). (Sb)

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