Substantial evidence exists to support the conclusion that the benefits of aspirin in decreasing the risk of serious medical conditions, such as stroke and heart attack, and death outweigh the potential minor increase in the incidence of wet AMD possibly associated with aspirin use. Patients who are taking aspirin for CV health should not fear the possible, theoretical, and exaggerated risks of exacerbating their AMD. Small, K, et. al. Retinal physician. Ophthalmology. V.107: 2224, v.112:533, v. 119:2282, v.123:352
Even if aspirin use were confirmed as an AMD risk factor using more robust study data, it is already apparent that the risk would be quite small in absolute terms, at approximately 1% for aspirin users and 0.5% for nonusers, which is not clinically meaningful. There are currently good treatment options for neovascular AMD, yet for CVDs and other similar conditions, aspirin is one of the main treatment options. The AMD and aspirin association is extremely limited, and the presumptions that have been made are not based on persuasive empirical data. Small, K, et. al. Retinal physician. Ophthalmology. V.107: 2224, v.112:533, v. 119:2282, v.123:352
AREDS reported that aspirin is actually beneficial in the protection of dry AMD patients. A larger study, AREDS showed the possible benefits of aspirin use for macular degeneration. AREDS studies 1, 3, and 19 noted that the association between aspirin and AMD is not statistically significant. The case-controlled AREDS reported that the use of anti-inflammatory medications, including aspirin, did have a protective effect on dry AMD. A recent review and meta-analysis demonstrated that there were no differences between novel oral anticoagulants and other antithrombotic drugs in the risk of substantial intraocular bleeding. In the Comparison of AMD Treatments Trials (CATT), the investigators attempted to determine the association between the use of anticoagulants/antiplatelets and retinal hemorrhage. Among 1,165 participants with active neovascular AMD, they found no significant association between the use of antiplatelets/anticoagulants and retinal hemorrhage at baseline.
Small, K, et. al. Retinal physician. Ophthalmology. V.107: 2224, v.112:533, v. 119:2282, v.123:352