Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Oct;121(10):1949-55.
doi: 10.1016/j.ophtha.2014.04.040. Epub 2014 Jun 20.

Cigarette smoking and the natural history of age-related macular degeneration: the Beaver Dam Eye Study

Chelsea E Myers  1 , Barbara E K Klein  2 , Ronald Gangnon  3 , Theru A Sivakumaran  4 , Sudha K Iyengar  5 , Ronald Klein  2
Affiliations

Cigarette smoking and the natural history of age-related macular degeneration: the Beaver Dam Eye Study

Chelsea E Myers et al. Ophthalmology. 2014 Oct.

Abstract

Purpose: To examine the association of current cigarette smoking and pack-years smoked with the incidence and progression of age-related macular degeneration (AMD) and to examine the interactions of current smoking and pack-years smoked with complement factor H (CFH, rs1061170) and age-related maculopathy susceptibility 2 (ARMS2, rs10490924) genotype.

Design: A longitudinal population-based study of AMD in a representative American community. Examinations were performed every 5 years over a 20-year period.

Participants: A total of 4439 participants in the population-based Beaver Dam Eye Study (BDES).

Methods: Age-related macular degeneration status was determined from grading retinal photographs. Multi-state models were used to model the relationship of current smoking and pack-years smoked and interactions with CFH and ARMS2 with the incidence and progression of AMD over the entire age range.

Main outcome measures: Incidence and progression of AMD over a 20-year period and interactions between current smoking and pack-years smoked with CFH and ARMS2 genotype.

Results: The incidence of early AMD over the 20-year period was 24.4%, and the incidence of late AMD was 4.5%. Current smoking was associated with an increased risk of transitioning from minimal to moderate early AMD. A greater number of pack-years smoked was associated with an increased risk of transitioning from no AMD to minimal early AMD and from severe early AMD to late AMD. Current smoking and a greater number of pack-years smoked were associated with an increased risk of death. There were no statistically significant multiplicative interactions between current smoking or pack-years smoked and CFH or ARMS2 genotype.

Conclusions: Current smoking and a greater number of pack-years smoked increase the risk of the progression of AMD. This has important health care implications because smoking is a modifiable behavior.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest Disclosures: No conflicting relationship exists for any author.

Figures

Figure 1
Figure 1
The 3-Continent Consortium five-step severity scale for age-related macular degeneration (AMD). Arrows indicate possible transitions along the scale. Hazard ratios indicate the hazard of making the transition indicated by the arrow for a current smoker compared to a non-current smoker (HR1) and per 5 pack-years smoked (HR2), adjusted for age and sex. AMD, age-related macular degeneration; HR, hazard ratio.
Figure 2
Figure 2
Distribution of current smoking by age and sex in the Beaver Dam Eye Study.
Figure 3
Figure 3
Distribution of pack-years smoked by age and sex in the Beaver Dam Eye Study.
See this image and copyright information in PMC

References

    1. Congdon N, O’Colmain B, Klaver CC, et al. Causes and prevalence of visual impairment among adults in the United States. Arch Ophthalmol. 2004;122:477–85. - PubMed
    1. Ferris FL, III, Tielsch JM. Blindness and visual impairment: a public health issue for the future as well as today. Arch Ophthalmol. 2004;122:451–2. - PubMed
    1. Friedman DS, O’Colmain BJ, Munoz B, et al. Prevalence of age-related macular degeneration in the United States. Arch Ophthalmol. 2004;122:564–72. - PubMed
    1. Chakravarthy U, Wong TY, Fletcher A, et al. Clinical risk factors for age-related macular degeneration: a systematic review and meta-analysis. BMC Ophthalmol. 2010;10:31. - PMC - PubMed
    1. Thornton J, Edwards R, Mitchell P, et al. Smoking and age-related macular degeneration: a review of association. Eye (Lond) 2005;19:935–44. - PubMed

Publication types