Adverse effects of smoking on patients with ocular inflammation

• Published in: British journal of ophthalmology Vol. 94; no. 7; pp. 848 - 853
• Main Authors: Galor, Anat, Feuer, William, Kempen, John H, Kaçmaz, R Oktay, Liesegang, Teresa L, Suhler, Eric B, Foster, C Stephen, Jabs, Douglas A, Levy-Clarke, Grace A, Nussenblatt, Robert B, Rosenbaum, James T, Thorne, Jennifer E
• Format: Journal Article
• Language: English
• Published: BMA House, Tavistock Square, London, WC1H 9JR BMJ Publishing Group Ltd 01.07.2010; BMJ Publishing Group; BMJ Publishing Group LTD
• Subjects: Adult; Aged; Biological and medical sciences; Cataracts; Disease; Endophthalmitis - epidemiology; Endophthalmitis - etiology; Endophthalmitis - physiopathology; Epidemiologic Methods; Eye surgery; Female; HIV; Human immunodeficiency virus; Humans; Immunology; Inflammation; Male; Medical sciences; Middle Aged; Miscellaneous; ocular inflammation; Ophthalmology; Prognosis; Recurrence; Smoking; Smoking - adverse effects; Smoking - epidemiology; Surgery; Time Factors; Tobacco; Tobacco, tobacco smoking; Toxicology; United States - epidemiology; Variance analysis; Visual Acuity; United States; Human; Eye; Ocular; Tobacco smoking; Secondary effect; Inflammation; Ophthalmology
• ISSN: 0007-1161; 1468-2079
• DOI: 10.1136/bjo.2009.174466

BackgroundTo evaluate how smoking affects the time to disease quiescence and time to disease recurrence in patients with ocular inflammation.MethodsA retrospective cohort study of patients with ocular inflammation who were followed longitudinally and had smoking information available in the Systemic Immunosuppressive Therapy for Eye Diseases Cohort Study database.ResultsAmong 2676 patients with active ocular inflammation, smokers were more likely to have bilateral ocular disease and poorer visual acuity on presentation compared with non-smokers and previous smokers. In a multivariate analysis, there was no statistically significant difference in the time to disease quiescence between groups. However, the median time to recurrence of ocular inflammation was statistically significantly longer for non-smokers (9.4 months) and for previous smokers (10.7 months) than for current smokers (7.8 months) (p=0.02). The RR of ocular inflammation recurrence was higher for smokers than for non-smokers (adjusted HR=1.19, 95% CI 1.03 to 1.37) and tended towards significance in previous smokers (adjusted HR=1.11, 95% CI 0.93 to 1.35).ConclusionsSmoking was associated with an increased likelihood of bilateral ocular inflammation and reduced vision upon presentation, and an increased risk of recurrence compared with not smoking. These results suggest that patients with ocular inflammation should be counselled to stop smoking as part of routine management.