title: Cigarette smoking and the natural history of age-related macular degeneration: the Beaver Dam Eye Study.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  A longitudinal population-based study of AMD in a representative American community. Examinations were performed every 5 years over a 20-year period.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
authors: Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. Electronic address: myers@epi.ophth.wisc.edu.
authors: Chelsea E
authors: CE
authors: Myers
authors: Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
authors: Barbara E K
authors: BE
authors: Klein
authors: Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin; Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
authors: Ronald
authors: R
authors: Gangnon
authors: Department of Epidemiology & Biostatistics, Genetics and Ophthalmology, Case Western Reserve University, Cleveland, Ohio.
authors: Theru A
authors: TA
authors: Sivakumaran
authors: Department of Epidemiology & Biostatistics, Genetics and Ophthalmology, Case Western Reserve University, Cleveland, Ohio; Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
authors: Sudha K
authors: SK
authors: Iyengar
authors: Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
authors: Ronald
authors: R
authors: Klein
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017242:Complement Factor H / Q000235:genetics; D018450:Disease Progression; D005260:Female; D005838:Genotype; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008268:Macular Degeneration / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D020641:Polymorphism, Single Nucleotide; D011506:Proteins / Q000235:genetics; D012907:Smoking / Q000009:adverse effects*; D014922:Wisconsin / Q000453:epidemiology
chemical_list: C514392:ARMS2 protein, human; C493495:CFH protein, human; D011506:Proteins; D017242:Complement Factor H