Does smoking influence the type of age related macular degeneration causing visual impairment?
OBJECTIVE
To assess the influence of smoking on the type of age related macular degeneration (AMD) lesion causing visual impairment in a large cohort of patients with AMD at a tertiary referral UK centre.


METHODS
Prospective, observational, cross sectional study to analyse smoking data on 711 subjects, of western European origin, in relation to the type of AMD lesion present. Colour fundus photographs were graded according to a modified version of the international classification. Multiple logistic regression analysis was performed, adjusting for age and sex using the statistical package SPSS ver 9.0 for Windows. chi(2) tests were also used to assess pack year and ex-smoker data.


RESULTS
578 subjects were graded with neovascular AMD and 133 with non-neovascular AMD. There was no statistically significant association found between smoking status or increasing number of pack years and type of AMD lesion. The odds of "current smokers" compared to "non-smokers" developing neovascular rather than non-neovascular AMD when adjusted for age and sex was 1.88 (95% CI: 0.91 to 3.89; p = 0.09).


CONCLUSIONS
Smoking is known to be a risk factor for AMD and this study suggests that smokers are at no more risk of developing neovascular than atrophic lesions.
Dandekar
S S
SS
Professorial Unit, Moorfields Eye Hospital, 162 City Road, London EC1V 2PD, UK. sam@hitbits.co.uk
Jenkins
S A
SA
Peto
T
T
Bird
A C
AC
Webster
A R
AR
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D020256:Choroidal Neovascularization / Q000209:etiology; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D017678:Sex Distribution; D012907:Smoking / Q000009:adverse effects*