PhotoA new study creates a dilemma for older Americans and their physicians, fiinding an association between regular use of aspirin and macular degeneration, a leading cause of blindness in older people.

The study, published Online First by JAMA Internal Medicine, a JAMA Network publication, found the higher risk of age-related macular degeneration was independent of a history of heart disease and smoking.

Aspirin is one of the most widely used medications in the world and is commonly used in the prevention of cardiovascular disease, such as heart attack and ischemic stroke. While a recent study suggested that regular aspirin use was associated with macular degeneration, other studies have reported inconsistent findings.

Smoking is also a preventable risk factor for the disease, the authors write in the study background.

Gerald Liew, Ph.D., of the University of Sydney, Australia, and colleagues conducted the prospective analysis of data from an Australian study that included four examinations during a 15-year period. Of 2,389 participants, 257 individuals (10.8 percent) were regular aspirin users.

After the 15-year follow-up, 63 individuals (24.5 percent) developed incident neovascular macular degeneration, according to the results.

“Regular aspirin use was significantly associated with an increased incidence of neovascular macular degeneration,” the researchers said, noting that any decision concerning whether to stop aspirin therapy is “complex and needs to be individualized.”

“Currently, there is insufficient evidence to recommend changing clinical practice, except perhaps in patients with strong risk factors for neovascular macular degeneration (e.g., existing late macular degeneration in the fellow eye) in whom it may be appropriate to raise the potentially small risk of incident neovascular macular degeneration with long-term aspirin therapy,” the authors concluded.