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The association between cigarette smoking and primary open-angle glaucoma: a systematic review
Vageesh Jain1, Mishank Jain2, Mohammed M Abdull3,4
1School of Life Sciences & Medicine, King's College London, London, SE1 1UL, UK. vageesh.jain@kcl.ac.uk.
International Ophthalmology
|May 4, 2016
Summary
Smoking may increase the risk of primary open-angle glaucoma (POAG), especially in heavy smokers. Current smoking shows a stronger link to POAG than past smoking, warranting further research into dose-response effects.
Area of Science:
- Ophthalmology
- Public Health
- Epidemiology
Background:
- Glaucoma is a leading cause of irreversible blindness worldwide.
- Elevated intraocular pressure (IOP) is a primary risk factor for glaucoma.
- Previous reviews on smoking and primary open-angle glaucoma (POAG) yielded inconsistent results and lacked recent dose-response data.
Purpose of the Study:
- To comprehensively evaluate the current literature on the association between smoking and POAG.
- To investigate the dose-response relationship between smoking and POAG risk.
Main Methods:
- Systematic literature search of MEDLINE (1946-2015) using keywords 'open-angle glaucoma' and 'cigarette' or 'smoking' or 'tobacco'.
- Inclusion criteria applied by two independent reviewers.
- Extraction of odds ratios (ORs) and 95% confidence intervals (CIs) for smoking-related POAG risk.
Main Results:
- 17 studies (9 case-control, 5 cohort, 3 cross-sectional) were included.
- Six case-control studies indicated a positive association between smoking and POAG.
- Recent large studies, including a prospective cohort study, found a significant POAG risk increase in very heavy smokers.
Conclusions:
- Limited evidence suggests a causal link between tobacco smoking and POAG.
- Current smoking appears more strongly associated with POAG than past smoking.
- Heavy smoking may increase POAG risk; further research on dose-response is recommended.
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