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Response to Comments on 'Smoking and Risk of Uveitis: A Systematic Review and Meta-Analysis'
Marjolein Drent1,2,3, Sanela Kuč4,5, Roel Erckens4
1Interstitial Lung Disease (ILD) Care Foundation, Research Team, Ede, The Netherlands.
Ocular Immunology and Inflammation
|November 25, 2025
Summary
Smoking is a significant modifiable risk factor for uveitis, increasing disease odds. Quitting smoking or vaping may improve treatment outcomes and prevent recurrence for patients with immune-mediated inflammatory diseases.
Area of Science:
- Ophthalmology
- Immunology
- Public Health
Background:
- Smoking is a known modifiable risk factor for various health conditions.
- Uveitis is an inflammatory eye condition with significant visual morbidity.
- The impact of smoking on uveitis and its treatment response requires further elucidation.
Purpose of the Study:
- To reaffirm the association between smoking and uveitis.
- To explore the biological mechanisms linking smoking to uveitis.
- To assess the influence of smoking on treatment outcomes for immune-mediated diseases, including uveitis.
Main Methods:
- Meta-analysis of existing studies.
- Review of biological mechanisms (oxidative stress, endothelial dysfunction, cytokine activation).
- Analysis of treatment response data in smokers with immune-mediated diseases.
Main Results:
- Consistent evidence confirms smoking as a major risk factor for uveitis across subtypes.
- Smoking is linked to reduced remission rates in patients undergoing biologic therapy for immune-mediated diseases.
- Tobacco use contributes to systemic and ocular complications like macular edema.
Conclusions:
- Clinicians should strongly advise patients to cease smoking or vaping.
- Reducing smoking can potentially enhance treatment efficacy, decrease inflammation, and prevent uveitis recurrence.
- Ophthalmologists are crucial in preventing uveitis and optimizing patient outcomes.
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