The Impact of Smoking on the Incidence of Different Glaucoma-Related Conditions

Abstract

Purpose : To study the impact of smoking on the incidence of different glaucoma-related conditions.

Methods : From the American Academy of Ophthalmology IRIS^® Registry with about 60 million ophthalmic patients in the US, we extracted the most recent available smoking history for glaucoma (ICD-10 codes H40.*) and non-glaucoma patients of at least 18 years of age. The smoking history was coded into three categories including never, former and current smokers. We compared the disease incidence rates for 13 glaucoma-related conditions including anatomical narrow angle (ANA), steroid responder, ocular hypertension, primary open-angle glaucoma (POAG), low-tension glaucoma (LTG), pigmentary glaucoma, pseudoexfoliation (PXF) glaucoma, acute angle-closure glaucoma (AACG), chronic angle-closure glaucoma (CACG), intermittent angle-closure glaucoma (IACG), and glaucoma secondary to eye trauma, inflammation and medications. Chi-squared test was used to test if the disease prevalence was higher for ever smokers than never smokers. P values were corrected for multiple comparisons.

Results : Approximately 9.85 million non-glaucoma patients and 1.23 million glaucoma patients were selected. The five glaucoma-related conditions with the highest percentages of current smokers (Table 1) were glaucoma secondary to eye trauma (17.6%), AACG (13.0%), glaucoma secondary to eye trauma (12.5%), pigmentary glaucoma (11.6%) and ocular hypertension (10.1%) compared with non-glaucoma (9.5%). The five glaucoma-related conditions with the highest percentages of former smokers (Table 1) were PXF glaucoma (27.1%), LTG (25.4%), steroid responder (24.8%), POAG (23.6%) and AACG (23.3%) compared with non-glaucoma (18.7%). All 13 glaucoma-related conditions except IACG and glaucoma secondary to medications in ever smokers (Table 2) had significantly higher prevalence compared with never smokers with risk ratios ranging from 1.69 (Glaucoma secondary to eye trauma) to 1.10 (ANA). The top five glaucoma-related conditions with the highest risk ratios were glaucoma secondary to eye trauma (1.69), AACG (1.43), glaucoma secondary to eye inflammation (1.36), steroid responder (1.28) and PXF glaucoma (1.28). The risk ratio of POAG in ever smokers to never smokers was 1.17.

Conclusions : Compared with never smokers, patients with a smoking history had increased risk to have glaucoma-related conditions with risk ratios ranging from 1.69 to 1.10 in IRIS Registry.

This is a 2020 ARVO Annual Meeting abstract.

 

Table 1

 

Table 2