Any risk-benefit analysis also must consider the availability of effective -- but expensive -- treatments for neovascular age-related macular degeneration.
"Any decision concerning whether to stop aspirin is thus complex and needs to be individualized," they wrote.
Limitations of the study included the possibility of confounding by indication and a lack of information on the reasons why participants were taking aspirin.
In their invited commentary, Kaul and Diamond wrote, "These findings are, at best, hypothesis-generating that should await validation in prospective randomized studies before guiding clinical practice or patient behavior."
They also advised that the choice of whether to use aspirin should focus on whether the indication is for secondary cardiovascular disease prevention, "where the benefits of aspirin are indisputable and greatly exceed the risk," or for primary prevention, where the evidence is less clear, as well as the extent of the person's risk for macular degeneration and bleeding.
"In the final analysis, decisions about aspirin use are best made by balancing the risks against the benefits in the context of each individual's medical history and value judgments," they added.
Other experts, such as Dr. Shawn Wilker of University Hospitals Case Medical Center in Cleveland agreed on the importance of individual risk.
"I think a reasonable circumstance when you could ask a patient not to take aspirin might be one in which there is a very low risk of mortality from cardiovascular disease or if that person is at very great risk of losing vision from macular degeneration," Wilker said in an interview.
Journal editor Dr. Kenneth E. Covinsky also weighed in in an editor's note, stating that "as with many good studies, the data are not definitive enough to suggest changes in clinical practice."
"Rather, we hope the study galvanizes more research on the relationship between aspirin and macular degeneration," Covinsky wrote.