Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Causal relationship between aspirin use and age-related macular degeneration

Eye (2026) Cite this article

Subjects

Abstract

Objective

Although increasing evidence suggests an association between aspirin use and age-related macular degeneration (AMD), the potential causal relationship between them remains controversial. This study aims to explore the causal genetic association and potential mediators between aspirin use and AMD using Mendelian randomisation (MR) analysis.

Methods

A bidirectional, two-sample, two-step MR analysis was performed to assess the potential causal relationships among aspirin use, AMD, and possible mediators. Multivariable MR was additionally performed to estimate the direct effect of aspirin use on AMD after adjusting for mediators. Causal estimates were primarily derived using an inverse variance weighted method. Horizontal pleiotropy, heterogeneity, and stability were evaluated using the MR-Egger intercept test, Cochran’s Q test, and leave-one-out analysis.

Results

An MR analysis revealed that aspirin use was associated with an increased risk of both early and dry AMD. A mediation analysis indicated that aspirin use is associated with a lower level of serum low-density lipoprotein cholesterol (LDL-C), an elevated serum apolipoprotein A1 (APOA1) concentration, and an increased risk of early and dry AMD. Multivariable MR analysis further showed that after adjusting for LDL-C and APOA1, the direct effect of aspirin on AMD was attenuated to non-significance.

Conclusion

This study provides robust genetic evidence that aspirin use is associated with an increased risk of early and dry AMD, and demonstrates that this association is fully mediated by decreased serum LDL-C and increased serum APOA1 levels, with no evidence of a direct effect independent of these lipid pathways.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on SpringerLink
  • Instant access to the full article PDF.

USD 39.95

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Schematic overview of the MR study design.
The alternative text for this image may have been generated using AI.
Fig. 2: Scatter plots of MR analysis of aspirin use and AMD using five different MR methods to assess the causal effects.
The alternative text for this image may have been generated using AI.
Fig. 3: Scatter plots for the causal association among aspirin use, AMD and mediators.
The alternative text for this image may have been generated using AI.

Similar content being viewed by others

Data availability

The datasets generated and analysed during the current study are available from the corresponding author on reasonable request.

References

  1. Fleckenstein M, Keenan TDL, Guymer RH, Chakravarthy U, Schmitz-Valckenberg S, Klaver CC, et al. Age-related macular degeneration. Nat Rev Dis Prim. 2021;7:31.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Guymer RH, Campbell TG. Age-related macular degeneration. Lancet. 2023;401:1459–72.

    Article  CAS  PubMed  Google Scholar 

  3. Stahl A. The diagnosis and treatment of age-related macular degeneration. Dtsch Ärztebl Int. 2020;117:513–20.

    PubMed  PubMed Central  Google Scholar 

  4. Han X, Chen Y, Gordon I, Safi S, Lingham G, Evans J, et al. A systematic review of clinical practice guidelines for age-related macular degeneration. Ophthalmic Epidemiol. 2023;30:213–20.

    Article  CAS  PubMed  Google Scholar 

  5. Ricci F, Bandello F, Navarra P, Staurenghi G, Stumpp M, Zarbin M. Neovascular age-related macular degeneration: therapeutic management and new-upcoming approaches. Int J Mol Sci. 2020;21.

  6. Holz FG, Sadda SR, Busbee B, Chew EY, Mitchell P, Tufail A, et al. Efficacy and safety of Lampalizumab for geographic atrophy due to age-related macular degeneration: Chroma and Spectri Phase 3 randomized clinical trials. JAMA Ophthalmol. 2018;136:666–77.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Heier JS, Lad EM, Holz FG, Rosenfeld PJ, Guymer RH, Boyer D, et al. Pegcetacoplan for the treatment of geographic atrophy secondary to age-related macular degeneration (OAKS and DERBY): two multicentre, randomised, double-masked, sham-controlled, phase 3 trials. Lancet. 2023;402:1434–48.

    Article  CAS  PubMed  Google Scholar 

  8. Montinari MR, Minelli S, De Caterina R. The first 3500 years of aspirin history from its roots - A concise summary. Vasc Pharm. 2019;113:1–8.

    Article  CAS  Google Scholar 

  9. Vane JR, Botting RM. The mechanism of action of aspirin. Thromb Res. 2003;110:255–8.

    Article  CAS  PubMed  Google Scholar 

  10. Baigent C, Blackwell L, Collins R, Emberson J, Godwin J, Peto R, et al. Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet. 2009;373:1849–60.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Fanaroff AC, Hasselblad V, Roe MT, Bhatt DL, James SK, Steg PG, et al. Antithrombotic agents for secondary prevention after acute coronary syndromes: A systematic review and network meta-analysis. Int J Cardiol. 2017;241:87–96.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Lièvre M, Cucherat M. Aspirin in the secondary prevention of cardiovascular disease: an update of the APTC meta-analysis. Fundam Clin Pharm. 2010;24:385–91.

    Article  Google Scholar 

  13. Desborough MJR, Keeling DM. The aspirin story - from willow to wonder drug. Br J Haematol. 2017;177:674–83.

    Article  PubMed  Google Scholar 

  14. Anderson DH, Radeke MJ, Gallo NB, Chapin EA, Johnson PT, Curletti CR, et al. The pivotal role of the complement system in aging and age-related macular degeneration: hypothesis re-visited. Prog Retin Eye Res. 2010;29.

  15. Tzoumas N, Riding G, Williams MA, Steel DH. Complement inhibitors for age-related macular degeneration. Cochrane Database Syst Rev. 2023;6:CD009300.

    PubMed  PubMed Central  Google Scholar 

  16. Xu X, Ritz B, Coleman AL, Liew Z, Deapen D, Lee E, et al. Non-steroidal anti-inflammatory drug use and risk of age-related macular degeneration in the California Teachers Study. Drugs Aging. 2021;38:817–28.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Yang T-M, Huang W-L, Yang C-H, Yang C-M, Ho T-C, Chen T-C, et al. Association between non-steroidal anti-inflammatory drug use and development of age-related macular degeneration-A 10-year retrospective cohort study. J Formos Med Assoc. 2024;123:467–77.

    Article  CAS  PubMed  Google Scholar 

  18. Modjtahedi BS, Fong DS, Jorgenson E, Van Den Eeden SK, Quinn V, Slezak JM. The relationship between nonsteroidal anti-inflammatory drug use and age-related macular degeneration. Am J Ophthalmol. 2018;188:111–22.

    Article  CAS  PubMed  Google Scholar 

  19. Christen WG, Glynn RJ, Ajani UA, Schaumberg DA, Chew EY, Buring JE, et al. Age-related maculopathy in a randomized trial of low-dose aspirin among US physicians. Arch Ophthalmol. 2001;119:1143–9.

    Article  CAS  PubMed  Google Scholar 

  20. Lee W-JA, Yang Y-HK, Cheng C-L. Risk of age-related macular degeneration in aspirin users and non-aspirin users: A population-based cohort study in Taiwan. Pharmacoepidemiol Drug Saf. 2021;30:178–88.

    Article  CAS  PubMed  Google Scholar 

  21. de Jong PTVM, Chakravarthy U, Rahu M, Seland J, Soubrane G, Topouzis F, et al. Associations between aspirin use and aging macula disorder: the European Eye Study. Ophthalmology. 2012;119:112–8.

    Article  PubMed  Google Scholar 

  22. el Baba F, Jarrett WH, Harbin TS, Fine SL, Michels RG, Schachat AP, et al. Massive hemorrhage complicating age-related macular degeneration Clinicopathologic correlation role of anticoagulants.Ophthalmolgy. 1986;93:1581–92.

    Article  CAS  Google Scholar 

  23. Kiernan DF, Hariprasad SM, Rusu IM, Mehta SV, Mieler WF, Jager RD. Epidemiology of the association between anticoagulants and intraocular hemorrhage in patients with neovascular age-related macular degeneration. Retina. 2010;30:1573–8.

    Article  PubMed  Google Scholar 

  24. Klein BEK, Howard KP, Gangnon RE, Dreyer JO, Lee KE, Klein R. Long-term use of aspirin and age-related macular degeneration. JAMA. 2012;308:2469–78.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Liew G, Mitchell P, Wong TY, Rochtchina E, Wang JJ. The association of aspirin use with age-related macular degeneration. JAMA Intern Med. 2013;173:258–64.

    Article  CAS  PubMed  Google Scholar 

  26. Christen WG, Glynn RJ, Chew EY, Buring JE. Low-dose aspirin and medical record-confirmed age-related macular degeneration in a randomized trial of women. Ophthalmology. 2009;116:2386–92.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Buitendijk GHS, Schauwvlieghe A-SME, Vingerling JR, Schlingemann RO, Klaver CCW. Antiplatelet and anticoagulant drugs do not affect visual outcome in neovascular age-related macular degeneration in the BRAMD Trial. Am J Ophthalmol. 2018;187:130–7.

    Article  CAS  PubMed  Google Scholar 

  28. Rim TH, Yoo TK, Kwak J, Lee JS, Kim SH, Kim DW, et al. Long-term regular use of low-dose aspirin and neovascular age-related macular degeneration: National Sample Cohort 2010-2015. Ophthalmology. 2019;126:274–82.

    Article  PubMed  Google Scholar 

  29. Keenan TD, Wiley HE, Agrón E, Aronow ME, Christen WG, Clemons TE, et al. The association of aspirin use with age-related macular degeneration progression in the age-related eye disease studies: Age-Related Eye Disease Study 2 Report No. 20. Ophthalmology. 2019;126:1647–56.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Robman LD, Wolfe R, Woods RL, Thao LTP, Makeyeva GA, Hodgson LAB, et al. Effect of low-dose aspirin on the course of age-related macular degeneration: a secondary analysis of the ASPREE randomized clinical trial. JAMA Ophthalmol. 2024;142:627–35.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Smith GD, Ebrahim S. ‘Mendelian randomization’: can genetic epidemiology contribute to understanding environmental determinants of disease? Int J Epidemiol. 2003;32.

  32. Thanassoulis G, O’Donnell CJ. Mendelian randomization: nature’s randomized trial in the post-genome era. JAMA. 2009;301:2386–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Julian TH, Cooper-Knock J, MacGregor S, Guo H, Aslam T, Sanderson E, et al. Phenome-wide Mendelian randomisation analysis identifies causal factors for age-related macular degeneration. Elife. 2023;12.

  34. Han X, Ong J-S, An J, Hewitt AW, Gharahkhani P, MacGregor S. Using Mendelian randomization to evaluate the causal relationship between serum C-reactive protein levels and age-related macular degeneration. Eur J Epidemiol. 2020;35:139–46.

    Article  CAS  PubMed  Google Scholar 

  35. Wang T, Chen J, Wang J, Zhang Y, Mao W, Yi Q. 91 Circulating inflammatory proteins and the risk of age-related macular degeneration: A bidirectional Mendelian randomization study. Int Immunopharmacol. 2024;139:112678.

    Article  CAS  PubMed  Google Scholar 

  36. Han G, Wei P, He M, Jia L, Su Q, Yang X, et al. Role of plasma fatty acid in age-related macular degeneration: insights from a Mendelian randomization analysis. Lipids Health Dis. 2024;23:206.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Li F-F, Wang Y, Chen L, Chen C, Chen Q, Xiang L, et al. Causal effects of serum lipid biomarkers on early age-related macular degeneration using Mendelian randomization. Genes Nutr. 2023;18:11.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Han X, Ong J-S, Hewitt AW, Gharahkhani P, MacGregor S. The effects of eight serum lipid biomarkers on age-related macular degeneration risk: a Mendelian randomization study. Int J Epidemiol. 2021;50:325–36.

    Article  PubMed  Google Scholar 

  39. Kuan V, Warwick A, Hingorani A, Tufail A, Cipriani V, Burgess S, et al. Association of Smoking, Alcohol Consumption, Blood Pressure, Body Mass Index, and glycemic risk factors with age-related macular degeneration: A Mendelian randomization study. JAMA Ophthalmol. 2021;139:1299–306.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Chen L, Qiu W, Sun X, Gao M, Zhao Y, Li M, et al. Novel insights into causal effects of serum lipids and lipid-modifying targets on cholelithiasis. Gut. 2024;73:521–32.

    Article  CAS  PubMed  Google Scholar 

  41. Klimentidis YC, Arora A, Newell M, Zhou J, Ordovas JM, Renquist BJ, et al. Phenotypic and genetic characterization of lower LDL cholesterol and increased Type 2 Diabetes risk in the UK Biobank. Diabetes. 2020;69:2194–205.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Kurki MI, Karjalainen J, Palta P, Sipilä TP, Kristiansson K, Donner KM, et al. FinnGen provides genetic insights from a well-phenotyped isolated population. Nature. 2023;613:508–18.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Winkler TW, Grassmann F, Brandl C, Kiel C, Günther F, Strunz T, et al. Genome-wide association meta-analysis for early age-related macular degeneration highlights novel loci and insights for advanced disease. BMC Med Genomics. 2020;13:120.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Emdin CA, Khera AV, Kathiresan S. Mendelian randomization. JAMA. 2017;318:1925–6.

    Article  PubMed  Google Scholar 

  45. Burgess S, Thompson SG. Avoiding bias from weak instruments in Mendelian randomization studies. Int J Epidemiol. 2011;40:755–64.

    Article  PubMed  Google Scholar 

  46. Shim H, Chasman DI, Smith JD, Mora S, Ridker PM, Nickerson DA, et al. A multivariate genome-wide association analysis of 10 LDL subfractions, and their response to statin treatment, in 1868 Caucasians. PLoS One. 2015;10:e0120758.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Dai J, Suo L, Xian H, Pan Z, Zhang C. Investigating the impact of Sun/UV protection and ease of skin tanning on the risk of Pseudoexfoliation Glaucoma: A Mendelian randomization study. Invest Ophthalmol Vis Sci. 2023;64:4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Skrivankova VW, Richmond RC, Woolf BAR, Yarmolinsky J, Davies NM, Swanson SA, et al. Strengthening the reporting of observational studies in epidemiology using Mendelian randomization: the STROBE-MR statement. JAMA. 2021;326:1614–21.

    Article  PubMed  Google Scholar 

  49. Hemani G, Zheng J, Elsworth B, Wade KH, Haberland V, Baird D, et al. The MR-Base platform supports systematic causal inference across the human phenome. Elife. 2018;7.

  50. Liu Y, Xiao X, Yang Y, Yao R, Yang Q, Zhu Y, et al. The risk of Alzheimer’s disease and cognitive impairment characteristics in eight mental disorders: A UK Biobank observational study and Mendelian randomization analysis. Alzheimer's Dement. 2024;20:4841–53.

    Article  CAS  Google Scholar 

  51. Gao N, Ni M, Song J, Kong M, Wei D, Dong A. Causal relationship between tea intake and cardiovascular diseases: A Mendelian randomization study. Front Nutr. 2022;9:938201.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Tin A, Köttgen A. Mendelian randomization analysis as a tool to gain insights into causes of diseases: a primer. J Am Soc Nephrol. 2021;32:2400–7.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Gao Y, Fan Z-R, Shi F-Y. Hypothyroidism and rheumatoid arthritis: a two-sample Mendelian randomization study. Front Endocrinol. 2023;14:1179656.

    Article  Google Scholar 

  54. Thompson JR, Minelli C, Del Greco MF, Mendelian randomization using public data from Genetic Consortia. Int J Biostat. 2016;12.

  55. Warner TD, Mitchell JA. Cyclooxygenase-3 (COX-3): filling in the gaps toward a COX continuum?. Proc Natl Acad Sci USA. 2002;99:13371–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Ferhatbegović L, Mršić D, Kušljugić S, Pojskić B. LDL-C: The only causal risk factor for ASCVD. Why is it still overlooked and underestimated?. Curr Atheroscler Rep. 2022;24:635–42.

    Article  PubMed  Google Scholar 

  57. Al Rayyes O, Ahrén B, Florén CH. Enhancement of low density lipoprotein catabolism by non-steroidal anti-inflammatory drugs in cultured HepG2 cells. Eur J Pharm. 1999;372:311–8.

    Article  Google Scholar 

  58. Schoonjans K, Martin G, Staels B, Auwerx J. Peroxisome proliferator-activated receptors, orphans with ligands and functions. Curr Opin Lipido. 1997;8:159–66.

    Article  CAS  Google Scholar 

  59. Margrain TH, Boulton M, Marshall J, Sliney DH. Do blue light filters confer protection against age-related macular degeneration?. Prog Retin Eye Res. 2004;23:523–31.

    Article  CAS  PubMed  Google Scholar 

  60. Tserentsoodol N, Sztein J, Campos M, Gordiyenko NV, Fariss RN, Lee JW, et al. Uptake of cholesterol by the retina occurs primarily via a low density lipoprotein receptor-mediated process. Mol Vis. 2006;12:1306–18.

    CAS  PubMed  Google Scholar 

  61. Yin L, Shi Y, Liu X, Zhang H, Gong Y, Gu Q, et al. A rat model for studying the biological effects of circulating LDL in the choriocapillaris-BrM-RPE complex. Am J Pathol. 2012;180:541–9.

    Article  CAS  PubMed  Google Scholar 

  62. Muscella A, Stefàno E, Marsigliante S. The effects of exercise training on lipid metabolism and coronary heart disease. Am J Physiol Heart Circ Physiol. 2020;319:H76–H88.

    Article  CAS  PubMed  Google Scholar 

  63. Park K-H, Kim J-Y, Choi I, Kim J-R, Cho K-H. ω-6 (18:2) and ω-3 (18:3) fatty acids in reconstituted high-density lipoproteins show different functionality of anti-atherosclerotic properties and embryo toxicity. J Nutr Biochem. 2015;26:1613–21.

    Article  CAS  PubMed  Google Scholar 

  64. Baek J-H, Lim D, Park KH, Chae J-B, Jang H, Lee J, et al. Quantitative proteomic analysis of aqueous humor from patients with drusen and reticular pseudodrusen in age-related macular degeneration. BMC Ophthalmol. 2018;18:289.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  65. Johnson LV, Forest DL, Banna CD, Radeke CM, Maloney MA, Hu J, et al. Cell culture model that mimics drusen formation and triggers complement activation associated with age-related macular degeneration. Proc Natl Acad Sci USA. 2011;108:18277–82.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Crabb JW, Miyagi M, Gu X, Shadrach K, West KA, Sakaguchi H, et al. Drusen proteome analysis: an approach to the etiology of age-related macular degeneration. Proc Natl Acad Sci USA. 2002;99:14682–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  67. Nordestgaard LT, Tybjærg-Hansen A, Frikke-Schmidt R, Nordestgaard BG. Elevated Apolipoprotein A1 and HDL Cholesterol Associated with Age-related Macular Degeneration: 2 Population Cohorts. J Clin Endocrinol Metab. 2021;106:e2749–e58.

    Article  PubMed  Google Scholar 

  68. Lee Y, Seo JH. The potential causal association of Apolipoprotein A and B and age-related macular degeneration: A Mendelian Randomisation Study. Biomedicines. 2024;12.

  69. G HB, Rao VS, Kakkar VV. Friend turns foe: transformation of anti-inflammatory HDL to Proinflammatory HDL during acute-phase response. Cholesterol. 2011;2011:274629.

    Article  PubMed  Google Scholar 

  70. Eren E, Yilmaz N, Aydin O. High density Lipoprotein and its Dysfunction. Open Biochem J. 2012;6:78–93.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  71. Pikuleva IA, Curcio CA. Cholesterol in the retina: the best is yet to come. Prog Retin Eye Res. 2014;41:64–89.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  72. Datta S, Cano M, Ebrahimi K, Wang L, Handa JT. The impact of oxidative stress and inflammation on RPE degeneration in non-neovascular AMD. Prog Retin Eye Res. 2017;60:201–18.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  73. Jiang X, Liu X, Liu X, Wu X, Jose PA, Liu M, et al. Low-dose Aspirin treatment attenuates male rat salt-sensitive hypertension via Platelet Cyclooxygenase 1 and Complement Cascade Pathway. J Am Heart Assoc. 2020;9:e013470.

    Article  CAS  PubMed  Google Scholar 

  74. Nordestgaard BG, Langsted A. Lipoprotein(a) and cardiovascular disease. Lancet. 2024;404:1255–64.

    Article  CAS  PubMed  Google Scholar 

  75. Yang LG, March ZM, Stephenson RA, Narayan PS. Apolipoprotein E in lipid metabolism and neurodegenerative disease. Trends Endocrinol Metab. 2023;34:430–45.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  76. Hodkinson A, Tsimpida D, Kontopantelis E, Rutter MK, Mamas MA, Panagioti M. Comparative effectiveness of statins on non-high density lipoprotein cholesterol in people with diabetes and at risk of cardiovascular disease: systematic review and network meta-analysis. BMJ. 2022;376:e067731.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

We thank all participants and investigators from the UK Biobank, FinnGen study, and IEU GWAS database.

Funding

This work was supported by grants from the National Key R&D Program of China (2023YFC2506100), the National Natural Science Foundation of China (82220108016 and U25A6002), the Guangzhou Basic Research Program (2024A03J0263 and 2024A03J0172), the Program for Supporting and Cultivating Outstanding Scientific and Technological Talents, Zhongshan Ophthalmic Center, Sun Yat-sen University (GCCRC-2026006), and the GBRCE for Major Blinding Eye Diseases Prevention and Treatment, and Research Funds of the State Key Laboratory of Ophthalmology (20250ZLH08).

Author information

Author notes

  1. These authors contributed equally: Juanhua Zhu, Chenggong Zeng, Rongsui Tang.

Authors and Affiliations

  1. State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China

    Juanhua Zhu, Rongsui Tang, Weiwei Lu, Shasha Wang, Lijuan Huang, Zhen Xiong, Rongyuan Chen & Xuri Li

  2. State Key Laboratory of Oncology in South China, Sun Yat-Sen Cancer Center, Sun Yat-Sen University, Guangzhou, China

    Chenggong Zeng & Zijun Zhen

  3. Affiliated Hospital of Shandong Second Medical University, School of Clinical Medicine, Shandong Second Medical University, Weifang, China

    Aijun Deng

Authors
  1. Juanhua Zhu
    View author publications

    Search author on:PubMed Google Scholar

  2. Chenggong Zeng
    View author publications

    Search author on:PubMed Google Scholar

  3. Rongsui Tang
    View author publications

    Search author on:PubMed Google Scholar

  4. Weiwei Lu
    View author publications

    Search author on:PubMed Google Scholar

  5. Shasha Wang
    View author publications

    Search author on:PubMed Google Scholar

  6. Lijuan Huang
    View author publications

    Search author on:PubMed Google Scholar

  7. Zhen Xiong
    View author publications

    Search author on:PubMed Google Scholar

  8. Aijun Deng
    View author publications

    Search author on:PubMed Google Scholar

  9. Zijun Zhen
    View author publications

    Search author on:PubMed Google Scholar

  10. Rongyuan Chen
    View author publications

    Search author on:PubMed Google Scholar

  11. Xuri Li
    View author publications

    Search author on:PubMed Google Scholar

Contributions

Zijun Zhen, Rongyuan Chen, and Xuri Li were responsible for designing the study. Juanhua Zhu, Chenggong Zeng, and Rongsui Tang were responsible for collecting and analysing data. Weiwei Lu and Shasha Wang were responsible for interpreting the results. Juanhua Zhu and Chenggong Zeng were responsible for writing the manuscript. Lijuan Huang and Zhen Xiong were responsible for providing critical revisions that are important for the intellectual content. Aijun Deng was responsible for providing feedback on the report. Zijun Zhen, Rongyuan Chen, and Xuri Li were responsible for approving the final version of the manuscript.

Corresponding authors

Correspondence to Zijun Zhen, Rongyuan Chen or Xuri Li.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhu, J., Zeng, C., Tang, R. et al. Causal relationship between aspirin use and age-related macular degeneration. Eye (2026). https://doi.org/10.1038/s41433-026-04574-2

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Version of record:

  • DOI: https://doi.org/10.1038/s41433-026-04574-2

Search

Advanced search

Quick links