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Senior Citizen Health & Medicine
More Proof that Smoking Increases Risk of
Age-Related Macular Degeneration, Blindness for Senior Citizens
Current smokers 4 times more likely to develop AMD;
past smokers 3 times as likely to have advanced form of the disease
 Aug. 13, 2007 - Current and past smokers appear to
have a higher risk of developing late age-related macular degeneration,
the leading cause of blindness in senior citizens, than those who have
never smoked, according to a report in the July issue of Archives of
Ophthalmology, one of the JAMA/Archives journals.
Age-related macular degeneration (AMD) - a
progressive eye disease that affects the central portion of the retina -
is the leading cause of blindness in the Western world, according to
background information in the article.
In addition to smoking, AMD is postulated to share
other risk factors with cardiovascular disease, such as elevated
cholesterol level and hypertension. Smoking may also interact with AMD
gene susceptibility and other environmental risk factors.
Jennifer S. L. Tan, M.B.B.S., B.E., University of
Sydney and Westmead Hospital, Sydney, Australia, and colleagues examined
2,454 Australians age 49 and older to study the association between
smoking and the 10-year incidence of AMD, as well as the possible links
between smoking and other common risk factors.
The participants answered a food frequency
questionnaire and had retinal photos taken at five-year and 10-year
follow-up exams. An interviewer-administered questionnaire assessed
participants smoking status. BMI and blood pressure were also measured.
Current smokers were found to be four times more
likely to develop age-related macular degeneration and past smokers were
three times as likely to have geographic atrophy, an advanced form of
the disease, than those who had never smoked.
Joint exposure to current smoking and (1) the
lowest level of high-density lipoprotein (HDL) [good] cholesterol, (2)
the highest total to HDL cholesterol ratio, or (3) low fish consumption
was associated with a higher risk of late AMD than the effect of any
risk factor alone.
However, interactions between smoking and HDL
cholesterol level, ratio of total to HDL cholesterol and fish
consumption were not statistically significant, the authors say.
In summary, the findings from this large
population-based prospective study add evidence to a possible causal
relationship between smoking and the long-term risk of late, but not
early, AMD, the authors conclude.
This supports speculation that AMD is a condition
with multiple etiologic factors, and such joint effects contributing to
the pathogenesis (origin and development) of AMD could mirror the
pathogenesis of cardiovascular disease.
Editor's Note: This study was supported in part by
grants from the Australian National Health and Medical Research Council.
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