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Lena V. Chheda, Amy K. Ferketich, Charles P. Carroll, Paul D. Moyer, Daryl E. Kurz, Paul A. Kurz; Smoking as a Risk Factor for Choroidal Neovascularization in Presumed Ocular Histoplasmosis Syndrome. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3609.
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© ARVO (1962-2015); The Authors (2016-present)
To determine whether smoking is a risk factor for the development of choroidal neovascularization (CNV) in patients with presumed ocular histoplasmosis syndrome (POHS).
Retrospective case-control study. Following IRB approval, a medical record review was performed for 568 patients within the age range of 18-50 years. Data was first collected on all 142 patients diagnosed with CNV secondary to POHS in a private retina practice between 7/1/2000 and 8/1/2010. Age, gender, zip code, diagnosis date, insurance status, and smoking status at the time of diagnosis were recorded. Data was then collected on 426 randomly selected patients (age 18-50) from a private comprehensive ophthalmology practice at the same location. Age, gender, zip code, date of visit, reason for visit, insurance status, and smoking status were recorded. For each of the 142 POHS patients, 3 comprehensive clinic patients (whose date of visit was within a 3-month window on either side of the date of CNV diagnosis in the corresponding POHS patient) served as controls. Using the recorded data, descriptive statistics were calculated for cases and controls. Univariate odds ratios (OR) and 95% confidence intervals (CI) were estimated using logistic regression. Variables that were significant in the univariate analyses were examined in a multivariable model. Those variables that were not significant were removed one at a time, in order of the least significance.
The mean age of POHS patients afflicted with CNV was 39±7.1 years, while that of the control patients was 35.7±9.1 years. Of the patients with CNV secondary to POHS, 47.2% were current/former smokers (42.3% current, 4.9% former). Of the control patients, 22.5% were current/former smokers (21.8% current, 0.7% former). Age, insurance status, and smoking status were significant in the univariate models. In the final adjusted logistic regression model, only age (OR 1.04, 95% CI, 1.02-1.07) and smoking status (OR 3.01, 95% CI, 2.01-4.52) were significant.
The odds of a smoker developing CNV secondary to POHS are approximately 3 times that of a nonsmoker.
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