Cigarette smoking and age-related macular degeneration in the EUREYE study

被引：166

作者：

Chakravarthy, U.

Augood, C.

Bentham, G. C.

de Jong, P. T. V. M.

Rahu, M.

Seland, J.

Soubrane, G.

Tomazzoli, L.

Topouzis, F.

Vingerling, J. R.

Vioque, J.

Young, I. S.

Fletcher, A. E.

机构：

[1] Univ London London Sch Hyg & Trop Med, Dept Epidemiol & Populat Hlth, London WC1E 7HT, England

[2] Queens Univ Belfast, Dept Ophthalmol, Belfast, Antrim, North Ireland

[3] Univ E Anglia, Ctr Environm Risk, Norwich NR4 7TJ, Norfolk, England

[4] Acad Med Ctr, Netherlands Ophthalm Res Inst, Royal Netherlands Acad Arts & Sci, Amsterdam, Netherlands

[5] Acad Med Ctr, Dept Ophthalmol, Amsterdam, Netherlands

[6] Natl Inst Hlth Dev, Dept Epidemiol & Biostat, Tallinn, Estonia

[7] Haykeland Sykehus Univ Bergen, Bergen, Norway

[8] Univ Paris 12, Clin Ophthalmol, Paris, France

[9] Univ Verona, Clin Oculist, I-37100 Verona, Italy

[10] Aristotle Univ Thessaloniki, Dept Ophthalmol, GR-54006 Thessaloniki, Greece

[11] Erasmus MC, Dept Ophthalmol, Rotterdam, Netherlands

[12] Erasmus MC, Dept Epidemiol & Biostat, Rotterdam, Netherlands

[13] Univ Miguel Hernandez, Dipartimento Salud Publ, Alicante, Spain

[14] Queens Univ Belfast, Ctr Clin & Populat Sci, Belfast, Antrim, North Ireland

来源：

OPHTHALMOLOGY | 2007年 / 114卷 / 06期

关键词：

D O I：

10.1016/j.ophtha.2006.09.022

中图分类号：

R77 [眼科学];

学科分类号：

100212 ;

摘要：

Objective: To examine the association between cigarette smoking and age-related maculopathy (ARM) including age-related macular degeneration (AMD) in the European population. Design: Cross-sectional study. Participants: Four thousand seven hundred fifty randomly sampled >= 65-year-olds from 7 study centers across Europe (Norway, Estonia, United Kingdom, France, Italy, Greece, and Spain). Methods: Participants underwent an eye examination and digital retinal photography. The images were graded at a single center. Smoking history was ascertained by a structured questionnaire administered by trained fieldworkers. Multinomial and binary logistic regressions were used to examine the association between smoking history and ARM grade and type of AMD, taking account of potential confounders and the multicenter study design. Main Outcome Measures: Photographic images were graded according to the International Classification System for ARM and stratified using the Rotterdam staging system into 5 exclusive stages (ARM 0-3 and ARM 4, also known as AMD). Age-related macular degeneration also was classified as neovascular AMD or geographic atrophy (GA). Results: One hundred fifty-eight cases were categorized as AMD (109 neovascular AMD and 49 GA); 2260 had no signs of ARM (ARM 0). Current smokers had increased odds of neovascular AMD (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.4-4.8) or GA (OR, 4.8; 95% CI, 2.1-11.1), whereas for ex-smokers the odds were around 1.7. Compared with people with unilateral AMD, those with bilateral AMD were more likely to have a history of heavy smoking in the previous 25 years (OR, 5.1; 95% CI, 1.3-20.0). The attributable fraction for AMD due to smoking was 27% (95% CI, 19%-33%). There was no consistent association with ARM grades 1 to 3 and smoking. Conclusions: These findings highlight the need for increasing public awareness of the risks associated with smoking and the benefit of quitting smoking. Patients with unilateral disease who are current smokers should be advised of the risk of second-eye disease.

引用

页码：1157 / 1163

页数：7

共 33 条

[31] The risk and natural course of age-related maculopathy - Follow-up at 61/2 years in the Rotterdam study [J].