Smoking Raises Risk Of Late Age-related Macular Degeneration

Editor's Choice
Main Category: Smoking / Quit Smoking
Also Included In: Eye Health / Blindness
Article Date: 14 Aug 2007 - 14:00 PDT

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If you are a smoker you run a significantly higher risk of developing AMD (age-related macular degeneration) than a person who has never smoked, says a report in Archives of Ophthalmology (JAMA/Archives), July 2007 issue. AMD is a progressive eye disease affecting the central portion of the retina, it is the leading cause of blindness in the Western world.

The writers explained that in addition to smoking, AMD is postulated to share other risk factors with cardiovascular disease, such as elevated cholesterol level and high blood pressure (hypertension).

Jennifer S. L. Tan, M.B.B.S., B.E., University of Sydney and Westmead Hospital, Sydney, Australia, and team looked at 2,454 participants aged at least 49 to see if there was a link between smoking and AMD risk over a ten-year-period. They also looked out for links between smoking and other illnesses. The volunteers completed a food frequency questionnaire and had photos of their retinas taken. Follow-up photos were taken of their retinas five and ten years later. They completed a questionnaire about their smoking status with the help of an interviewer. Details were also taken of each participant's BMI and blood pressure.

The researchers found that..:

-- People who currently smoke have four times the risk of developing AMD, compared to lifelong non-smokers
-- People who used to smoke, but don't any more, have three times the risk of having geographic atrophy (advanced form of the disease), compared to lifelong non-smokers

The authors wrote "Joint exposure to current smoking and (1) the lowest level of high-density lipoprotein (HDL) [good] cholesterol, (2) the highest total to HDL cholesterol ratio, or (3) low fish consumption was associated with a higher risk of late AMD than the effect of any risk factor alone. However, interactions between smoking and HDL cholesterol level, ratio of total to HDL cholesterol and fish consumption were not statistically significant."

"In summary, the findings from this large population-based prospective study add evidence to a possible causal relationship between smoking and the long-term risk of late, but not early, AMD," the authors conclude. "This supports speculation that AMD is a condition with multiple etiologic factors, and such joint effects contributing to the pathogenesis (origin and development) of AMD could mirror the pathogenesis of cardiovascular disease," the researchers concluded.

"Smoking and the Long-term Incidence of Age-Related Macular Degeneration - The Blue Mountains Eye Study"
Jennifer S. L. Tan, MBBS, BE; Paul Mitchell, MD, PhD; Annette Kifley, MBBS, MAppStat; Victoria Flood, MPH, PhD; Wayne Smith, PhD, FAFPHM; Jie Jin Wang, MMed, PhD
Arch Ophthalmol. 2007;125:1089-1095.
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Written by: Christian Nordqvist
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