Medication Use and the 5-Year Incidence of Early Age-Related Maculopathy

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Abstract
AGE-RELATED maculopathy (ARM) is an important cause of visual loss in persons 65 years or older.1,2 Its pathogenesis is not well understood.3,4 Aside from family history, and to a lesser extent cigarette smoking, there are few strong or consistent associations with ARM.5 One particular class of exposure has not been widely studied with respect to ARM, namely, use of medications. Anecdotal cases of associations between the use of steroids and neovascular ARM have been reported.6 A study by el Baba et al7 described 15 patients with ARM complicated by massive subretinal and/or vitreous hemorrhages, of whom 8 were taking oral anticoagulants, salicylates, or salicylate-like medications. However, no relation between aspirin use and the presence8 or incidence of ARM9 was found in 2 other studies. In the Age-Related Eye Disease Study, use of hydrochlorothiazide diuretic was associated with the presence of large retinal drusen but not with geographic atrophy or exudative macular degeneration.10 In Oulu, Finland,8 and in Melton Mowbray, England,11 there were no associations found between use of antihypertensive medications or sedatives and the presence of early or late ARM.