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B.E. Munoz, S.K. West, G.S. Rubin, A.T. Broman, S. Bressler; SMOKING AND TWO–YEAR PROGRESSION OF AGE RELATED MACULOPATHY IN A POPULATION BASED SAMPLE OF OLDER AMERICANS: THE SALISBURY EYE EVALUATION . Invest. Ophthalmol. Vis. Sci. 2004;45(13):3092.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To report the association of smoking with the two year progression of ARM among participants in the SEE project Methods: The SEE project is a population–based study of 2520 persons living in the Salisbury metropolitan area aged 65 to 84 years at enrollment. Stereo fundus photographs for each eye taken at the first two visits were graded for the presence, severity, location of drusen, RPE abnormalities, evidence of choroidal neovascularization and geographic atrophy within 3000 µ radius of the foveal center. Detailed demographic, medical and smoking history were obtained at baseline. To measure progression during the two years between visits, eyes were classified according to the following scale: stage 1 as presence of drusen 64 µ to 125 µ without pigmentary abnormalities, stage 2 as presence of drusen >125 µ or pigmentary abnormalities, stage 3 (advanced AMD) presence of neovascular AMD or geographic atrophy (stage 0 if none of the signs described above were present). Progression was defined as moving at least one step in the scale. Results: Of the eyes at risk for progression (i.e. stages 0 and 1 at baseline when considering progression to stage 2) , 1.4% (46/3267) progressed to advanced AMD, 5.9% (112/1897) progressed to stage 2, and 12.5% (203/1620) progressed to stage 1 over two years. After adjusting for age, race, gender, initial stage, and accounting for the correlation between eyes, current smoking was associated with a two–fold increase in the risk of progression to stage 2 (OR 1.96, 95%CI 1.17–3.30). Findings were similar when using smoking dose. No significant association with smoking was found with progression to stage 1. Risk factor analyses were not done on the small number of participants who progressed to stage 3. Conclusions: Smoking, and smoking dose, may be involved in the progression from early macular changes to the high–risk characteristics associated with the development of advanced AMD. These results warrant consideration of smoking cessation, as it may be relevant to AMD progression.
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