Smoking and the 5-year incidence of age-related maculopathy - The Blue Mountains Eye Study
Smoking and the 5-year incidence of age-related maculopathy - The Blue Mountains Eye Study
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DOI：
10.1001/archopht.120.10.1357
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发表时间：
2002-10-01
影响因子：
--
通讯作者：
Leeder, SR
中科院分区：
文献类型：
--
作者：
Mitchell, P;Wang, JJ;Leeder, SR
目的：评估基线吸烟与晚期和早期年龄相关性黄斑病变5年发病率之间的关系。(ARM)方法：蓝山眼科研究在1992年至1994年期间检查了3654名年龄在49岁或以上的参与者，然后在5年后检查了2335名幸存者（75.1%）。使用威斯康星州视网膜相关黄斑病变分级系统对视网膜照片进行分级。采用与比弗坝眼科研究相似的并行方法，对任一检查时有任何ARM病变的患者进行详细重新分级。我们还使用了类似的ARM病变定义。结果：任何晚期ARM病变的标准化发病率分别为3.1%，1.2%和1.4%，基线当前，过去，或从不吸烟者。相应的年龄标准化发病率。早期ARM分别为10.6%、8.2%和9.3%。基线当前吸烟者发生晚期ARM的平均年龄为67岁，既往吸烟者为73岁，从未吸烟者为77岁（P= 0.02）。经年龄校正后，与从不吸烟者相比，目前吸烟者发生地图样萎缩（年龄校正相对风险[RR]，3.6; 95%置信区间[CI]，1.1-11.3）和任何晚期ARM病变（RR，2.5; 95% CI，1.0-6.2）的风险增加。目前吸烟者发生视网膜色素异常的风险增加（RR，1.7; 95% CI，1.1-2.7），男性风险更高（RR，2.8; 95%CI，1.4-5.6）。结果测量：早期ARM、晚期ARM和ARM病变的5年发生率。在该队列中，目前吸烟者发生5年晚期ARM病变和视网膜色素异常的风险增加。目前吸烟者在显着更早的年龄比从来没有或过去的吸烟者发展晚期ARM。
Objective: To assess the relationship between baseline smoking and the 5-year incidence of late and early age-related maculopathy. (ARM) in an older population cohort.Methods: The Blue Mountains Eye Study examined 3654 participants aged 49 years or older during 1992 to 1994 and then 2335 survivors (75.1%) after 5 years. Retinal photographs were graded using the Wisconsin Age-Related Maculopathy Grading System. Those with any ARM lesions at either examination were regraded in detail using a side-by-side method similar to that developed for the Beaver Dam Eye Study. We also used similar definitions for incident ARM lesions. Smoking status was recorded at interview.Results: Age-standardized incidence rates for any late ARM lesions were 3.1%, 1.2%, and 1.4%, respectively,among baseline current, past, or never smokers. Corresponding age-standardized incidence rates. for early ARM were 10.6%, 8.2%, and 9.3%, respectively. The mean age for cases with incident late ARM was 67 years for base line current smokers, 73 years for past smokers, and 77 years for those who had never smoked (P=.02). After adjusting for age, current smokers, compared with never smokers, had an increased risk of incident geographic atrophy (age-adjusted relative risk [RR], 3.6; 95% confidence interval [CI], 1.1-11.3) and any late ARM lesions (RR, 2.5; 95% CI, 1.0-6.2). Current smokers had an increased risk of incident retinal pigmentary abnormalities (RR, 1.7; 95% CI, 1.1-2.7), with the risk higher in men (RR, 2.8; 95% CI, 1.4-5.6).Outcome Measures: Five-year incidence of early ARM, late ARM, and ARM lesions.Conclusions: In this cohort, persons who were current smokers had an increased risk of 5-year incident late ARM lesions and retinal pigmentary abnormalities. Current smokers developed late ARM at a significantly earlier age than never or past smokers.