Age-Related Macular Degeneration and Smoking: The Rotterdam Study
Abstract
OBJECTIVE: To assess the relation between cigarette smoking and age-related macular degeneration (AMD) in a population of elderly persons. DESIGN: A cross-sectional, community-based study. SETTING: City district of Rotterdam, the Netherlands. PARTICIPANTS: A total of 6174 persons 55 years and older who participated in the Rotterdam Study. In 36 persons atrophic AMD and in 65 persons neovascular AMD were diagnosed. MAIN OUTCOME MEASURES: Age-related macular degeneration was diagnosed by evaluating fundus transparencies, smoking behavior was identified by interviewing subjects, and the presence of atherosclerosis was assessed by the ankle-arm systolic blood pressure index. Relative risks and 95% confidence intervals (CIs) were calculated using multivariate logistic regression analysis. RESULTS: In subjects younger than 85 years, current smokers had a 6.6-fold increased risk of neovascular AMD vs those who had never smoked (95% CI, 2.8-15.9). Former smokers had a 3.2-fold increased risk of neovascular AMD vs nonsmokers in this age group (95% CI, 1.4-7.4). These associations were not observed in subjects 85 years or older. Smoking was not associated with atrophic AMD. A strong increased risk of neovascular AMD was present in those who had smoked more than 10 pack-years (relative risk, 6.5; 95% CI, 2.9-14.8). Adjusting the results for atherosclerosis did not change the association. Persons who had quit smoking 20 or more years before the eye examination had no increased risk. CONCLUSIONS: The results provide evidence for a dose-response relationship between smoking and AMD, particularly in persons with the neovascular form of the disease.
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Smoking is a modifiable and consistently associated environmental factor, typically resulting in about two-fold increased risk of developing advanced AMD.
“Smoking is a modifiable and consistently associated environmental factor, typically resulting in about two-fold increased risk of developing advanced AMD (3, 112, 150, 155).”
From Unraveling a Multifactorial Late-Onset Disease: From Genetic Susceptibility to Disease Mechanisms for Age-Related Macular Degeneration (2009) · cites this paper as [155]
Cigarette smoking is a risk factor for age-related macular degeneration, confirmed by case-control, population-based, and prospective studies.
“Results from a number of case-control studies,28–33 population-based studies,34–36 and prospective studies of both physicians37 and nurses38 strongly confirm cigarette smoking as a risk factor for age-related macular degeneration.”
From Age-related macular degeneration (2008) · cites this paper as [34]
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- Authors
- Vingerling, J. R.
- Affiliations
- Erasmus MC (NL)
- Corresponding author
- Vingerling, Johannes R.
- Venue
- Archives of Ophthalmology
- Publisher
- American Medical Association (AMA)
- Published
- 1996-10-01
- Volume
- 114
- Issue
- 10
- Pages
- 1193
- ISSN
- 0003-9950 (ISSN-L)
- OpenAlex
- W2146304086
- Cited by
- 246
- References
- 22
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 10 · 2023: 9 · 2022: 9 · 2021: 11 · 2020: 5 · 2019: 4 · 2018: 4 · 2017: 9 · 2016: 3 · 2015: 6 · 2014: 7 · 2013: 13 · 2012: 12
- FWCI
- 4.51
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Ophthalmology (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal Imaging and Analysis
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Keywords
- age-related macular degeneration, smoking, neovascular AMD, atrophic AMD, pack-years, smoking cessation, atherosclerosis, dose-response relationship, older adults, Rotterdam Study
- MeSH terms
- Aged, Aged, 80 and over, Choroid, Cross-Sectional Studies, Female, Follow-Up Studies, Humans, Macular Degeneration, Male, Middle Aged, Neovascularization, Pathologic, Netherlands, Retinal Hemorrhage, Risk Factors, Smoking, Incidence, Prevalence
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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