Monday, January 9, 2012

WECA is One Year Old, Daily Aspirin Use & Macular Degeneration

Hello,

Things have been busy at Weaver Eye Care Associates, as of late, which is a good sign. The practice achieved it's One Year Anniversary on January 3rd. So thank you to all of you for your help, support and patronage. The practice is growing...this January is much busier than the first time around, for sure. The word is getting out, so please keep it up...spreading the word about the practice.

Since things have been busy, I haven't had a chance to write an article in a while, so I've been feeling bad about that. I know that many of you look to my blog posts, as well as my Facebook and Twitter updates, to get the latest Weaver Eye Care Associates, optometry and eye care-related news.

So...I came across an article regarding aspirin use and the increased risk of macular degeneration...

A recent article at HealthDay.com reported that "Daily aspirin use among seniors may double their risk of developing" the "wet" form of "age-related macular degeneration (AMD), a significant cause of blindness in seniors."

HealthDay reported the summary of a study published in the January issue of the journal Ophthalmology, which said that, "daily aspirin use was associated with the onset of late-stage wet AMD, and to a lesser degree, the onset of early 'dry' AMD -- even after the researchers took into account age and a history of heart disease, which in itself is a risk factor for AMD." Specifically, late-stage 'wet' AMD was more than 2x more likely among daily aspirin users in a study population of 4,691 European seniors.

If you remember from my previous blog post about Macular Degeneration, you already know that the main risk factors of AMD are: 1) increasing age, 2) having light-hair/light-skin and 3) smoking. Also, AMD is still a leading cause of vision loss and affects over 1.75 million Americans

Also, to review, there are two forms of macular degeneration: dry and wet. Dry is the early form, and wet is the advanced/severe form. Dry AMD may never lead to wet AMD. Those with early, dry AMD may be lucky to not have significant vision loss, but blindness can occur in both forms, not just the wet AMD. However, both forms are bad and can cause decreased vision and blindness.


Got all of that?

Anyway, the recommendation from the article suggests doctors to "advise persons who [already] have early or late AMD not to take aspirin as a painkiller," and to "advise people with AMD who take small amounts of aspirin for primary prevention -- this means having no past history of cardiac or vascular problems like stroke, and no elevated risk factors for these diseases -- to discuss with their doctor if it is wise to continue doing so. For secondary prevention -- this means after having these elevated risks or disorders -- the benefits of daily aspirin outweigh the risks."


Older adults take aspirin to "thin the blood" in order to reduce the risk of heart attack and stroke, but here it seems that aspirin is contra-indicated for those with age-related macular degeneration. However, what is peculiar is that a 2004 study in the American Journal of Ophthalmology suggested that the use of statin drugs and aspirin (therapy to reduce risk heart attack and stroke, remember) in patients with AMD actually showed a decrease in likelihood of choroidal neovascular membrane (CNVM) formation. CNVM is commonly associated with wet AMD.

The 2004 study included only 326 patients, while the most recent study included 4691 participants.

To me, the most recent study seems to make sense. Those on blood-thinning medications, such as aspirin or Coumadin, are more prone to bruising as well as decreased wound healing. The CNVM is a collection of leaky blood vessels in association with the wet form of AMD. So if aspirin "thins the blood," it may have a more advantageous way to escape those leaky blood vessels in CNVM.

I feel the take home message is this: if you have AMD and are taking aspirin just for pain relief, and NOT to reduce the risk of heart attack and stroke, consider using another analgesic (Motrin, Tylenol, Aleve). If you have AMD and are taking aspirin due to a risk of heart attack and stroke, talk to your family doctor regarding the continued use of aspirin.

Obviously, more studies are needed regarding the relationship of aspirin and macular degeneration.

I hope this gives some guidance for yourself, or others that you may know that suffer from macular degeneration.

Sincerely,
Dr. Weaver



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