Adverse Effects of Smoking on Patients with Ocular Inflammation

Abstract

Purpose: : To evaluate how smoking affects the time-to-disease quiescence and time-to-disease recurrence in patients with ocular inflammation.

Methods: : Retrospective cohort study of patients with ocular inflammation who were followed longitudinally and had smoking information available in the Systemic Immunosuppressive Therapy for Eye Diseases Cohort Study database.

Results: : Among 2,676 patients with active ocular inflammation, smokers were more likely to have bilateral ocular disease and poorer visual acuity on presentation compared to nonsmokers and previous smokers. In a multivariate analysis, there was no statistically significant difference in the time-to-disease quiescence between groups. However, the median time-to-recurrence of ocular inflammation was statistically significantly longer for nonsmokers (9.4 months) and for previous smokers (10.7 months) than for current smokers (7.8 months) (p= 0.02). The relative risk of ocular inflammation recurrence was higher for smokers than nonsmokers (adjusted HR=1.19, 95% CI 1.03-1.37) and tended towards significant in previous smokers (adjusted HR=1.11, 95% CI 0.93-1.35).

Conclusions: : Smoking was associated with an increased likelihood of bilateral ocular inflammation and reduced vision upon presentation, and an increased risk of recurrence compared to nonsmokers. These results suggest that ocular inflammation patients should be counseled to stop smoking as part of routine management.

Keywords: uveitis-clinical/animal model • clinical (human) or epidemiologic studies: risk factor assessment • inflammation