Wu Yan, Zhu Wei, Li Yan-Hong, Yu Jing
Department of Ophthalmology, Affiliated Tenth People's Hospital of Tongji University, Shanghai 200072, China, ; Department of First Clinical Medical College, Nanjing Medical University, Nanjing, Jiangsu, China.
Department of Ophthalmology, Affiliated Tenth People's Hospital of Tongji University, Shanghai 200072, China.
Med Hypothesis Discov Innov Ophthalmol. 2013 Fall;2(3):59-68.
Age-related macular degeneration (AMD) is becoming the leading cause of blindness in developed countries. The exact etiology and pathophysiology of AMD is still unclear. A number of risk factors of AMD have been recognized, such as cigarette smoking, a family history of AMD and being Caucasian. On the other hand, aspirin is a widespread medication, which is thought to be associated with the prevalence or the survival of myocardial infarction and cancers. However, the evidence from the epidemiological studies has been contradictory and no persuasive conclusions have been made. Several problems, such as the parameters of aspirin use, the inclusion and exclusion of the participants and the required long-term follow-up, made it hard to conclude a definite relationship between aspirin use and AMD. Aspirin, as an anti-inflammatory agent, could prevent the inflammation and decrease the inflammatory damage, and might act as a deterrent for the progression of AMD. However, aspirin is an anticoagulant which might increase the risk of ocular hemorrhage in AMD patients. Decades ago, the use of aspirin was reported associated with decreased rates of CNV among AMD patients nevertheless recently, the association between aspirin use and increased risk of neovascular AMD was identified. Therefore, these current results should be challenged and acknowledged by well-designed, large-scale and long term follow-up studies. A consultation might be needed when aspirin is used in the neovascular AMD patients.
年龄相关性黄斑变性（AMD）正成为发达国家失明的主要原因。AMD的确切病因和病理生理学仍不清楚。已确认了一些AMD的危险因素，如吸烟、AMD家族史和白种人。另一方面，阿司匹林是一种广泛使用的药物，被认为与心肌梗死和癌症的患病率或生存率有关。然而，流行病学研究的证据相互矛盾，尚未得出有说服力的结论。阿司匹林使用参数、参与者的纳入和排除以及所需的长期随访等几个问题，使得很难确定阿司匹林使用与AMD之间的明确关系。阿司匹林作为一种抗炎剂，可以预防炎症并减少炎症损伤，可能对AMD的进展起到抑制作用。然而，阿司匹林是一种抗凝剂，可能会增加AMD患者眼部出血的风险。几十年前，据报道使用阿司匹林可降低AMD患者的脉络膜新生血管（CNV）发生率，然而最近，已确定阿司匹林使用与新生血管性AMD风险增加之间存在关联。因此，这些当前结果应通过精心设计、大规模和长期的随访研究进行验证和确认。在新生血管性AMD患者中使用阿司匹林时可能需要进行会诊。
