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2013-01-22 11:56:04
By James Gallagher Health and science reporter, BBC News
People who regularly take aspirin for many years, such as those with heart
problems, are more likely to develop a form of blindness, researchers say.
A study on 2,389 people, in the journal JAMA Internal Medicine, showed aspirin
takers had twice the risk of "wet" age-related macular degeneration.
The disease damages the 'sweet spot' in the retina, obscuring details in the
centre of a patient's field of vision.
The researchers said there was not yet enough evidence to change aspirin use.
Taking low doses of aspirin every day does reduce the risk of a stroke or heart
attack in patients with cardiovascular disease. There are even suggestions it
could prevent cancer.
One in 10 people in the study, conducted at the University of Sydney, were
taking aspirin at least once a week. On average the participants were in their
mid-60s.
Eye tests were performed after five, 10 and 15 years.
Start Quote
The evidence is now accumulating about the association of aspirin and wet AMD,
however, it is not overwhelming at this point
Macular Society
By the end of the study, the researchers showed that 9.3% of patients taking
aspirin developed wet age-related macular degeneration (AMD) compared with 3.7%
of patients who did not take aspirin.
Their report said: "The increased risk of [wet] AMD was detected only after 10
or 15 years, suggesting that cumulative dosing is important.
"Given the widespread use of aspirin, any increased risk of disabling
conditions will be significant and affect many people."
Wet AMD is caused by blood vessels growing in the wrong place. They cause
swelling and bleeding which damages the retina.
The process can happen very quickly with vision being damaged in days. Age,
smoking and a family history are the main risk factors.
High-risk
There are already known risks of aspirin such as causing internal bleeding. The
research team suggest the risk of damaging eyesight "may also need to be
considered".
They acknowledge that for most patients there is "insufficient evidence" to
change how aspirin is prescribed.
However, they suggested using the drug may need to be reappraised in high-risk
patients such as those with wet AMD in one eye already.
Prof Jie Jin Wang, an expert in vision research at Sydney University in
Australia, said this was something doctors might want to discuss with high-risk
patients.
The Macular Society said: "The evidence is now accumulating about the
association of aspirin and wet AMD, however, it is not overwhelming at this
point.
"For patients at risk of cardio-vascular disease, the health risks of stopping
or not prescribing aspirin are much higher than those of developing wet AMD.
"Patients who are taking aspirin because their doctor has prescribed it should
not stop taking it without consulting their doctor first."
Matthew Athey, from the RNIB charity, said any concerns should be discussed
with a family doctor.
"However, this is interesting research as age-related macular degeneration
(AMD) is the leading cause of sight loss in the UK, and this study could
contribute to our understanding about why some people may develop 'wet' type
macular degeneration.
"Further research is needed to clarify and investigate some of the issues
raised in the study, however this association may be valuable for doctors in
the future when considering aspirin for their patients."