title: Association of smoking and other risk factors with Fuchs' endothelial corneal dystrophy severity and corneal thickness.
abstract: OBJECTIVE
  We investigated effects of smoking and other risk factors on the development of advanced Fuchs' endothelial corneal dystrophy (FECD) and on central corneal thickness (CCT).
  
  
  METHODS
  Eyes from Caucasian probands, affected and unaffected family members, and unrelated controls matched for age from the FECD Genetics Multi-Center Study (n = 2044 subjects) were examined. Univariate and multivariate models, adjusted for family correlations, were used to determine the effect of smoking, sex, diabetes, and age on FECD case/control status and CCT.
  
  
  RESULTS
  In a multivariate model, sex and smoking were associated significantly with advanced FECD (grades 4-6) development (P = 0.016 and P = 0.047, respectively). Female sex increased odds by 34%. Smoking increased odds by 30%. In a multivariate model, diabetes was associated with an increase of 9.1 μm in average CCT (P = 0.021). Female sex was associated significantly with a decrease in average CCT by 6.9 μm (P = 0.015). Smoking had no significant effect on CCT in any model. As shown previously, advanced FECD was associated with large increases in CCT (31.4-94.2 μm).
  
  
  CONCLUSIONS
  Smoking was associated with an increased risk of advanced FECD and self-reported diabetes was associated with increased CCT. Further study of the impact of smoking and diabetes on FECD development and changes in corneal thickness is warranted.
authors.affiliation: Department of Ophthalmology and Visual Sciences, Case Western Reserve University and University Hospitals Eye Institute, Cleveland, Ohio, USA.
authors.forename: Xiaolin
authors.initials: X
authors.lastname: Zhang
authors.forename: Robert P
authors.initials: RP
authors.lastname: Igo
authors.forename: Jeremy
authors.initials: J
authors.lastname: Fondran
authors.forename: V Vinod
authors.initials: VV
authors.lastname: Mootha
authors.forename: Matt
authors.initials: M
authors.lastname: Oliva
authors.forename: Kristin
authors.initials: K
authors.lastname: Hammersmith
authors.forename: Alan
authors.initials: A
authors.lastname: Sugar
authors.forename: Jonathan H
authors.initials: JH
authors.lastname: Lass
authors.forename: Sudha K
authors.initials: SK
authors.lastname: Iyengar
mesh_terms: D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D003315:Cornea / Q000473:pathology*; D003920:Diabetes Mellitus; D005260:Female; D005642:Fuchs' Endothelial Dystrophy / Q000209:etiology* / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*
keywords: FECD; corneal endothelial cells; smoking