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Jesus Guerrero, Marisela Vazquez-Duran, Enrique O Graue-Hernandez, Aida Jimenez-Corona; Relationship between smoking and ocular diseases: a case-control study in a specialized hospital in Mexico City. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3793.
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© ARVO (1962-2015); The Authors (2016-present)
Smoking is regarded as a risk factor for several ocular diseases because of the oxidative stress and the ischemic microenvironment that it produces, which is directly related to the frequency, intensity, and time of exposure. This study was carried out to measure the association between several ocular diseases (dry eye syndrome, age-related macular degeneration, and cataract) and frequency and intensity of both active and passive smoking.
We carried out a case-control study from august 2015 to july 2016. As cases, we included patients 40 years and older enrolled at a specialized ophthalmological center with confirmed diagnosis of dry eye syndrome, age-related macular degeneration, or cataract. Controls: patients with refractive error and no evidence of the above mentioned ocular pathologies. The GATS (global adult tobacco survey) was used to determine exposure levels of active and passive smoking.
Of 296 patients (125 men and 171 women, average age 65.29, S.D. 12.42; 94), 83 had clinically significant cataract, 80 had dry eye syndrome, 50 had age-related macular degeneration, and 83 were controls. In the clinically significant cataract group, 12 patients were non-smokers (14.46%), 10 active smokers (12.05%), and 61 former smokers (73.49%, p= <0.001). In the dry eye syndrome group 40 patients were non-smokers (50%), 21 active smokers (26.25%), and 19 former smokers (23.75%). In the age-related macular degeneration group 19 patients were non-smokers (38%), 11 active smokers (22%), and 20 former smokers (40%). In the control group 40 patients were non-smokers (50.60%), 22 active smokers (26.51%), and 19 previous smokers (22.89%).In multiple logistic regression model, after adjusting for age, gender, and diabetes we found a significant association between clinically significant cataract and both former smoking (OR= 2.03; 95%CI 5.25-31.44; p<0.001) and active smoking (OR= 8.40; 95% CI 3.02-23.35; p<0.001). Also a significant association was observed age-related macular degeneration and former smoking (OR=4.57; 95%CI 1.48-8.18, p=0.008).
This study showed a strong association between smoking and both cataract and age-related macular degeneration, but not dry eye syndrome. Although the associated conditions are reversible (cataract) and not reversible (age-related macular degeneration), it is highly advisable to avoid exposure in both cases.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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