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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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In the citing paper
“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]
In the citing paper
“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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Metadata
- 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 › Public Health, Environmental and Occupational Health › 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
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