Department of Ophthalmology, the Second Affiliated Hospital of Zhejiang University, College of Medicine, Hangzhou, Zhejiang, China.
Invest Ophthalmol Vis Sci. 2014 Apr 25;55(4):2687-96. doi: 10.1167/iovs.13-13206.
We conducted a meta-analysis of randomized controlled trials (RCTs) and observational studies to evaluate the association between aspirin use and age-related macular degeneration (AMD).
The pertinent studies were identified via literature search through four databases (MEDLINE, Web of Science, Cochrane Library, Embase) and reference lists of retrieved studies. Randomized controlled trials and cohort and case-control studies meeting the predefined criteria were included. We extracted relative risk (RR) or odds ratio (OR) or hazard ratio (HR) and 95% confidence interval (CI) from each study. Overall and study-specific risk estimates were pooled using fixed-effects and random-effects models, respectively. Subgroup analyses based on several stratified factors were also performed.
In total, two RCTs, three cohort studies, and four case-control studies involving 177,683 subjects were included. The pooled effect of all nine studies showed no significant association between aspirin use and occurrence of AMD (RR, 1.00; 95% CI 0.96-1.04), and no significant association was observed in any specific study design (RR, 0.93; 95% CI 0.71-1.22 for RCT; RR, 1.02; 95% CI 0.87-1.20 for cohort study; RR, 1.00; 95% CI 0.96-1.04 for case-control study). However, subgroup analysis showed aspirin use to be significantly associated with an increased risk of neovascular AMD (RR, 1.59; 95% CI 1.09-2.31).
The pooled effects from current literature suggest that aspirin use is not associated with AMD, but it increased the risk of the neovascular form of AMD.
我们进行了一项荟萃分析,纳入了随机对照试验(RCT)和观察性研究,以评估阿司匹林使用与年龄相关性黄斑变性(AMD)之间的关联。
通过四个数据库(MEDLINE、Web of Science、Cochrane Library、Embase)和检索研究的参考文献进行文献检索,确定相关研究。纳入符合预定义标准的随机对照试验以及队列研究和病例对照研究。我们从每项研究中提取相对风险(RR)或优势比(OR)或风险比(HR)和 95%置信区间(CI)。使用固定效应和随机效应模型分别对总体和研究特异性风险估计值进行合并。还基于几个分层因素进行了亚组分析。
共纳入两项 RCT、三项队列研究和四项病例对照研究,涉及 177683 名受试者。所有 9 项研究的汇总效应表明,阿司匹林使用与 AMD 的发生之间无显著关联(RR,1.00;95%CI 0.96-1.04),任何特定研究设计均无显著关联(RR,0.93;95%CI 0.71-1.22 用于 RCT;RR,1.02;95%CI 0.87-1.20 用于队列研究;RR,1.00;95%CI 0.96-1.04 用于病例对照研究)。然而,亚组分析显示,阿司匹林使用与新生血管性 AMD 的风险增加显著相关(RR,1.59;95%CI 1.09-2.31)。
当前文献的汇总效应表明,阿司匹林使用与 AMD 无关,但增加了新生血管性 AMD 的风险。