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Cigarette Smoking and Age-Related Macular Degeneration in the EUREYE Study
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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“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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“Over the last decades epidemiological studies have identified a number of environmental factors that may increase the risk of AMD, including smoking (Baird et al. 2008, Chakravarthy et al. 2007, Cong et al. 2008, DeBlack.”
BackgroundDégénérescence maculaire liée à l’âge. État des lieux 2015
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“…previous population-based studies, and it is in contrast to other previous meta-analyses of population-based studies, in which smoking was associated with a higher risk of AMD (Bikbov et al., 2020; Chakravarthy et al., 2007; Fleckenstein et al., 2024; Guymer & Campbell, 2023; Sadda et al., 2018).”
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Fleckenstein, M., Schmitz-Valckenberg, S., & Holz, F. G. (2012) · Biological and medical physics series · doi:10.1007/978-3-642-27410-7_4 · Cited by 1
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BackgroundAge-Related Macular Degeneration and Mortality in the Age-Related Eye Disease Study (AREDS)
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Choroidal Findings in Systemic Disorders
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Nahrungsergänzungsmittel und „Lifestyle“
Christof, D., & Gamulescu, M. (2019) · Klinische Monatsblätter für Augenheilkunde · doi:10.1055/a-0972-9993 · Cited by 1
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BackgroundCigarette Smoking and Age-Related Macular Degeneration in the EUREYE Study
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The Epidemiology and Type of Macular Disease Seen in a Teaching Hospital in South-West, Nigeria
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Metadata
- 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.
- Venue
- Ophthalmology
- Publisher
- Elsevier BV
- Published
- 2007-06
- Volume
- 114
- Issue
- 6
- Pages
- 1157-1163
- ISSN
- 0161-6420 (ISSN-L)
- 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
- 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 › Public Health, Environmental and Occupational Health › 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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