Department of Ophthalmology, Southern California Permanente Medical Group, Baldwin Park, California; Eye Monitoring Center, Kaiser Permanente Southern California, Baldwin Park, California.
Department of Ophthalmology, Southern California Permanente Medical Group, Baldwin Park, California; Eye Monitoring Center, Kaiser Permanente Southern California, Baldwin Park, California; Department of Research and Evaluation, Southern California Permanente Medical Group, Pasadena, California.
Am J Ophthalmol. 2018 Apr;188:111-122. doi: 10.1016/j.ajo.2018.01.012. Epub 2018 Jan 31.
To describe the relationship between the incidence of age-related macular degeneration (AMD) and nonsteroidal anti-inflammatory drug (NSAIDs) use.
Prospective cohort study.
This study consisted of participants in the California Men's Health Study. Those who completed surveys in 2002-2003 and 2006 were included. Men who self-reported use of aspirin, ibuprofen, naproxen, valdecoxib, celecoxib, and/or rofecoxib at least 3 days per week were considered NSAID users. Patients were categorized as non-users, former users, new users, or longer-term users based on survey responses. NSAID use was also categorized by type: any NSAIDs, aspirin, and/or non-aspirin NSAIDs. Age, race/ethnicity, smoking status, education, income, alcohol use, and Charlson comorbidity index score were included in the multivariate analysis as risk factors for AMD.
A total of 51 371 men were included. Average follow-up time was 7.4 years. There were 292 (0.6%) and 1536 (3%) cases of exudative and nonexudative AMD, respectively. Longer-term use of any NSAID was associated with lower risk of exudative AMD (hazard ratio [HR] 0.69, 95% confidence interval [CI] 0.50-0.96, P = .029). New users of any NSAIDs (HR = 0.79, 95% CI 0.68-0.93, P = .0039) and aspirin (HR = 0.82, 95% CI 0.70-0.97, P = .018) had a lower risk of nonexudative AMD, although this trend did not persist in longer-term users. The relationship between exudative or nonexudative AMD and the remaining categories of NSAID use were not significant.
The overall impact of NSAIDs on AMD incidence is small; however, the lower risk of exudative AMD in longer-term NSAID users may point to a protective effect and deserves further study as a possible mechanism to modulate disease risk.
描述年龄相关性黄斑变性（AMD）的发病率与非甾体抗炎药（NSAIDs）使用之间的关系。
前瞻性队列研究。
本研究包括加利福尼亚男性健康研究的参与者。那些在 2002-2003 年和 2006 年完成调查的人被包括在内。那些每周至少服用 3 天阿司匹林、布洛芬、萘普生、伐地昔布、塞来昔布和/或罗非昔布的人被认为是 NSAIDs 使用者。根据调查结果，患者被归类为非使用者、前使用者、新使用者或长期使用者。NSAID 的使用也根据类型进行分类：任何 NSAIDs、阿司匹林和/或非阿司匹林 NSAIDs。年龄、种族/民族、吸烟状况、教育程度、收入、饮酒和 Charlson 合并症指数评分被纳入多变量分析，作为 AMD 的危险因素。
共有 51371 名男性被纳入研究。平均随访时间为 7.4 年。分别有 292 例（0.6%）和 1536 例（3%）出现渗出性和非渗出性 AMD。长期使用任何 NSAID 与渗出性 AMD 的风险降低相关（风险比[HR]0.69，95%置信区间[CI]0.50-0.96，P=0.029）。任何 NSAIDs 的新使用者（HR=0.79，95%CI 0.68-0.93，P=0.0039）和阿司匹林（HR=0.82，95%CI 0.70-0.97，P=0.018）的非渗出性 AMD 风险较低，尽管这种趋势在长期使用者中并不持续。渗出性或非渗出性 AMD 与 NSAID 使用的其余类别之间没有显著关系。
NSAIDs 对 AMD 发病率的总体影响较小；然而，长期 NSAID 使用者中渗出性 AMD 的风险降低可能表明存在保护作用，值得进一步研究，作为调节疾病风险的一种可能机制。
