I am happy to respond to Dr Ong's question, which was prompted by my letter on aspirin in the treatment of type 2 diabetes.1 The treatment of diabetic retinopathy in general was recently reviewed,2 and the place of aspirin in this context has been addressed by at least 2 studies3,4 that showed that aspirin did not affect the progression of retinopathy, the risk of visual loss,3 or the risk of vitreous hemorrhage among patients with proliferative retinopathy.4 However, it did reduce the risk of morbidity and death from cardiovascular disease by 17%.5 Therefore, aspirin should be considered for patients with type 2 diabetes, not because of any effect on diabetic retinopathy, but because of its effect of reducing cardiovascular risk. The presence of microaneurysms with or without proliferative retinopathy should not be a contradiction to aspirin therapy.
Kajubi SK. Aspirin in Diabetes: Beware of Retinopathy—Reply. Arch Intern Med. 2000;160(19):3004. doi: