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28 000 Cases of age related macular degeneration causing visual loss in people aged 75 years and above in the United Kingdom may be attributable to smoking
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  1. J R Evans1,
  2. A E Fletcher2,
  3. R P L Wormald3
  1. 1International Centre for Eye Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
  2. 2Non Communicable Disease Epidemiology Unit, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
  3. 3Moorfields Eye Hospital and International Centre for Eye Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
  1. Correspondence to: Jennifer R Evans International Centre for Eye Health, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK; Jennifer.evanslshtm.ac.uk

Abstract

Background: Age related macular degeneration (AMD) causing visual impairment is common in older people. Previous studies have identified smoking as a risk factor for AMD. However, there is limited information for the older population in Britain.

Methods: Population based cross sectional analytical study based in 49 practices selected to be representative of the population of Britain. Cases were people aged 75 years and above who were visually impaired (binocular acuity <6/18) as a result of AMD. Controls were people with normal vision (6/6 or better). Smoking history was ascertained using an interviewer administered questionnaire.

Results: After controlling for potentially confounding factors, current smokers were twice as likely to have AMD compared to non-smokers (odds ratio 2.15, 95% CI 1.42 to 3.26). Ex-smokers were at intermediate risk (odds ratio 1.13, 0.86 to 1.47). People who stopped smoking more than 20 years previously were not at increased risk of AMD causing visual loss. Approximately 28 000 cases of AMD in older people in the United Kingdom may be attributable to smoking.

Conclusion: This is the largest study of the association of smoking and AMD in the British population. Smoking is associated with a twofold increased risk of developing AMD. An increased risk of AMD, which is the most commonly occurring cause of blindness in the United Kingdom, is yet another reason for people to stop smoking and governments to develop public health campaigns against this hazard.

  • AMD, age related macular degeneration
  • ARM, age related maculopathy
  • age related macular degeneration
  • smoking
  • United Kingdom
  • AMD, age related macular degeneration
  • ARM, age related maculopathy
  • age related macular degeneration
  • smoking
  • United Kingdom
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Footnotes

  • Source of funding: The MRC Trial of the Assessment and Management of Older People in the Community was funded by the United Kingdom Medical Research Council, the Department of Health and the Scottish Office. Collection of data on causes of visual impairment was funded by the Gift of Thomas Pocklington. Researchers were independent of the funding body.

  • Competing interests: none declared

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