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Samuel Manhei Law, Xiang Lu, Fei Yu, Victoria L Tseng, Simon K Law, Anne L Coleman; The association between smoking and glaucoma in the United States population. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2575.
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© ARVO (1962-2015); The Authors (2016-present)
Controversy exists regarding the relationship between cigarette smoking and glaucoma. We perform a retrospective cross-sectional study to evaluate the association between smoking and glaucoma in participants from the National Health and Nutrition Examination Survey (NHANES).
US civilian, non-institutionalized population from 2005–2008 administrations of the NHANES that were 40 years of age or older with completed frequency doubling technology (FDT) visual fields and optic disc photographs, without non-glaucomatous explanation for abnormal optic disc appearance or visual field, and with information on smoking were included. Diagnosis of glaucoma was based on the Rotterdam criteria. Logistic regression modeling was performed to assess the association between glaucoma and smoking history, while controlling for age, gender, ethnicity, body mass index (BMI), and alcohol consumption.
In the study population of 3845 that satisfied the inclusion criteria, 210 (5.5%) participants had glaucoma, which corresponds to an overall population weighted glaucoma prevalence of 3.7% in a weighted total of 83,443,390 participants. The overall population weighted proportion of current smokers was 20.6% and ex-smokers was 28.3%. Older age (odds ratio [OR]=1.06, 95% CI=1.05, 1.08), male gender (OR=1.26, 95% CI=0.92, 1.73), Non-Hispanic blacks (OR=3.46, 95% CI=2.48, 4.83) and Hispanics/other race (OR=2.40, 95% CI=1.51, 3.81) were associated with higher odds of glaucoma. Comparing to non-smokers, ex-smokers had a higher odds of glaucoma (OR=1.30, 95% CI=0.90, 1.88), but current smokers had a statistically significantly lower odds of glaucoma (OR=0.61, 95% CI=0.41, 0.88). Within smokers (ex-smokers and current smokers), compared to the first quartile of the amount of smoking, defined by the total pack-years of smoking, heavy smoking (fourth quartile) had higher odds of glaucoma (OR=1.51, 95% CI=0.66, 3.44), while there was no apparent differences in the odds of glaucoma in other subgroups (second quartile: OR=0.93, 95% CI=0.40, 2.19; third quartile: OR=0.88, 95% CI=0.41, 1.90).
Cigarette smoking may have a protective effect against glaucoma. Participants who were current smokers had lower odds of glaucoma compared to non-smokers, and ex-smokers had an increased risk of glaucoma compared to non-smokers. However, heavy smoking may eliminate such protective effects.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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