Refractive error and smoking habits in exudative age-related macular degeneration in a hospital-based setting

To assess and compare refractive error and smoking habits in patients with exudative age-related macular degeneration (AMD) in a clinical setting.

The clinical comparative study included 379 patients (379 eyes) who underwent intravitreal application of an anti-vascular growth factor drug for the treatment of exudative AMD, and 191 patients without exudative macular degeneration and who underwent surgery for age-related cataract. Smoking status was compared with an age-matched control group of the German population described in the census of 2003. The main outcome measures were refractive error, axial length, and data from a questionnaire on smoking habits.

The AMD group compared with the cataract group showed a significantly shorter axial length (23.31+/-0.75 vs 24.20+/-1.56 mm; P<0.001) and was significantly more hyperopic (0.65+/-2.14 vs -1.71+/-4.57 dioptres; P<0.001). After the exclusion of pseudophakic AMD patients and matching by age and gender, the difference of refractive error and axial length between both groups remained to be statistically significant (P<0.001). The AMD group and the matched population group did not vary significantly in smoking history (age group: 55-75 years, current smokers: 18.4% vs 16.8% (P=0.64); former smokers: 23.2% vs 24.9% (P=0.66); age group>75 years, current smokers: 6.3% vs 6.4% (P=0.97); former smokers: 19.7% vs 22.8% (P=0.25)).

In our setting, an association was found between short axial length and AMD. We were not able to confirm the previously reported link between smoking and AMD.