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Cited by 230Retinal Diseases and TreatmentsRetinal Imaging and AnalysisSmoking Behavior and Cessation

Cigarette Smoking and Age-Related Macular Degeneration in the EUREYE Study

Chakravarthy, U., Augood, C., Bentham, G.C., de Jong, P.T.V.M., Rahu, M., Seland, J., Soubrane, G., Tomazzoli, L. +5 more·2007·Ophthalmology
DOI 10.1016/j.ophtha.2006.09.022
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Abstract

Objective To examine the association between cigarette smoking and age-related maculopathy (ARM) including age-related macular degeneration (AMD) in the European population.Design Cross-sectional study.Participants Four thousand seven hundred fifty randomly sampled > or =65-year-olds from 7 study centers across Europe (Norway, Estonia, United Kingdom, France, Italy, Greece, and Spain).Methods Participants underwent an eye examination and digital retinal photography. The images were graded at a single center. Smoking history was ascertained by a structured questionnaire administered by trained fieldworkers. Multinomial and binary logistic regressions were used to examine the association between smoking history and ARM grade and type of AMD, taking account of potential confounders and the multicenter study design.Main outcome measures Photographic images were graded according to the International Classification System for ARM and stratified using the Rotterdam staging system into 5 exclusive stages (ARM 0-3 and ARM 4, also known as AMD). Age-related macular degeneration also was classified as neovascular AMD or geographic atrophy (GA).Results One hundred fifty-eight cases were categorized as AMD (109 neovascular AMD and 49 GA); 2260 had no signs of ARM (ARM 0). Current smokers had increased odds of neovascular AMD (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.4-4.8) or GA (OR, 4.8; 95% CI, 2.1-11.1), whereas for ex-smokers the odds were around 1.7. Compared with people with unilateral AMD, those with bilateral AMD were more likely to have a history of heavy smoking in the previous 25 years (OR, 5.1; 95% CI, 1.3-20.0). The attributable fraction for AMD due to smoking was 27% (95% CI, 19%-33%). There was no consistent association with ARM grades 1 to 3 and smoking.Conclusions These findings highlight the need for increasing public awareness of the risks associated with smoking and the benefit of quitting smoking. Patients with unilateral disease who are current smokers should be advised of the risk of second-eye disease.

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  • The systematic review included 18 prospective and cross-sectional studies and 8 case control studies, contributing 94,058 patients and 3,178 late AMD cases.

    “In total, data from 18 prospective, cross-sectional studies and 8 case control studies [12,24-26,28,30,31,33-47,49-54,57-73] were included in the final analysis, contributing a sample of some 94,058 patients (ranging from 261 to 22,071) including 3,178 (ranging from 8 to 776) late AMD cases.”

    From Clinical risk factors for age-related macular degeneration: a systematic review and meta-analysis (2010) · cites this paper as [12]

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Authors
Chakravarthy, U., Augood, C., Bentham, G. C., de Jong, P. T. V. M., Rahu, M., Seland, J., Soubrane, G., Tomazzoli, L., Topouzis, F., Vingerling, J. R., Vioque, J., Young, I. S., & Fletcher, A. E.
Affiliations
  • Queen's University Belfast (GB)
  • London School of Hygiene & Tropical Medicine (GB)
  • University of East Anglia (GB)
  • National Institute for Health Development (EE)
  • Haukeland University Hospital (NO)
  • University of Verona (IT)
  • Aristotle University of Thessaloniki (GR)
  • Erasmus MC (NL)
Corresponding author
Fletcher, A.E.
ORCID
Venue
Ophthalmology
Publisher
Elsevier BV
Published
2007-06
Volume
114
Issue
6
Pages
1157-1163
ISSN
0161-6420 (ISSN-L)
DOI
10.1016/j.ophtha.2006.09.022
OpenAlex
W1966367482
Cited by
230
References
38
Citations by year
2026: 4 · 2025: 16 · 2024: 8 · 2023: 13 · 2022: 12 · 2021: 11 · 2020: 8 · 2019: 13 · 2018: 9 · 2017: 16 · 2016: 11 · 2015: 11 · 2014: 13 · 2013: 15 · 2012: 12
FWCI
13.81
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Ophthalmology (publishedVersion)
  • PubMed (publishedVersion)
  • Pure Amsterdam UMC (publishedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
  • Research Portal (Queen's University Belfast) (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
cigarette smoking, age-related macular degeneration, age-related maculopathy, neovascular AMD, geographic atrophy, smoking cessation, attributable fraction, older adults, risk factors
MeSH terms
Aged, Cross-Sectional Studies, Environment, Europe, Female, Humans, Life Style, Macular Degeneration, Male, Photography, Surveys and Questionnaires, Risk Factors, Smoking, Tobacco Smoke Pollution, Odds Ratio, Smoking Cessation, Choroidal Neovascularization

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