Smokers should be warned of the risks

A study published online ahead of print in Ophthalmology, has highlighted the associated risks between blindness and smoking and warns that people with unilateral age-related macular degeneration (AMD) and age-related maculopathy (ARM) should be advised that they are increasing their risk of developing the disease in the second-eye.

Usha Chakravathy and colleagues from Queen's University of Belfast, UK, randomly sampled 4750 patients (>/= 65 years) from seven study centres across Europe (Norway, Estonia, UK, France, Italy, Greece and Spain). Smoking history was ascertained by a structured questionnaire. Multinomial and binary logistic regressions were used to examine the association between smoking history and ARM grade and type of AMD.

Each participant underwent a full eye examination and digital retinal photography and the resulting images were graded at a single centre. Images were graded according to the International Classification System for ARM and stratified using the Rotterdam staging system into five stages (ARM 0-3 and ARM 4, also known as AMD). AMD was then classified as either neovascular AMD or geographic atrophy (GA).

A total of 158 cases were classified as AMD (109 neovascular AMD, 49 GA) and 2260 demonstrated no signs of ARM. 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 to those with unilateral AMD, those with bilateral AMD were more likely to have a history of heavy smoking in the previous 25 years. There was no consistent association with ARM grades 1 to 3 and smoking.

The authors of this study believe that their findings highlight the need for increased public awareness of the risks associated with smoking and the benefits of quitting smoking.