Study: Smoking (1994, 2006, 2015, 2016) & Macular Damage



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For the past several decades it has been known that the risk to smokers in developing macular degeneration was significant; depending on the particular study the risk factor was held to be from two to six times greater for smokers than for non-smokers.

2016 Researchers found that if patients with macular degeneration stop smoking early enough some of the damage caused by smoking is reversable. In addition they found that the connection between Alzheimer's and AMD is strengthened by the damaged caused by smoking.

Researchers: Sha Sha Yu, et al.
Published: Links between the Brain and Retina: The Effects of Cigarette Smoking-Induced Age-Related Changes in Alzheimer's Disease and Macular Degeneration, Frontiers in Neurology, July, 2016

Other researchers found that the seriousness of macular degeneration cases is greater in patients who smoke. Smokers who have a genetic predisposition to AMD are more likely to develop the condition than non-smokers with the same genetic risk.

Researchers: D. Stanislovaitiene, et al
Published: SCARB1 rs5888 is associated with the risk of age-related macular degeneration susceptibility and an impaired macular area, Ophthalmic Genetics, July, 2016


2015 Researchers decided to investigate chromosome 1 genotype (the largest chromosome with about 249 million DNA pairs) and damage, including smoking in tissue from the macula of smokers.

They found that the macula tissue of smokers had increased levels of genetic damage in the Bruch's membrane, one of the layers of the retina, and in the choroidal stroma (the layer of the retina containing blood vessels). Smoking was also associated with markedly elevated C-reactive protein, an indicator of inflammation. Finally, the macula tissue of smokers demonstrated high levels of stress due to free radicals (oxidative stress) in the pigmented layers of the macula (RPE).

Researchers: T.D. Keenan, M. Toso, C. Pappas, L. Nichols, P.N. Bishop, G.S. Hageman
Published: Assessment of Proteins Associated With Complement Activation and Inflammation in Maculae of Human Donors Homozygous Risk at Chromosome 1 CFH-to-F13B, Investigative Ophthalmology and Visual Science, July, 2015.


2006 This study investigated the relationship between pack-years. For example 20 pack years equals 20 cigarettes, or 1 pack per day for 20 years.

Researchers took a closer look at the ramifications of smoking and development of macular degeneration. The study was done with Caucasian subjects where 435 patients were compared to 280 controls. All of the patients had retinal photographs taken and the presence of advanced wet macular degeneration (choroid neovascularization) and advanced dry macular degeneration (geographic atrophy) was noted. The subjects completed a smoking history questionnaire.

Smokers, former smokers and non-smokers were compared. There were differences, but they were not statistically significant. But there was a significant association when pack-years were taken into consideration. Smokers with a 40 pack year history were about 3 1/2 times as likely to develop advanced dry macular degeneration and 2 1/2 times as likely to develop advanced wet macular degeneration. Smokers who quit smoking had better odds, and those who hadn't smoked in 20 years had similar results as non-smokers.

Researchers: J.C. Khan, D.A. Thurlby, et al.
Published: Smoking and age related macular degeneration: the number of pack years of cigarette smoking is a major determinant of risk for both geographic atrophy and choroidal neovascularisation, British Journal of Ophthalmology, January, 2006.


1994 Smokers with early macular degeneration who consumed the lowest amounts of carotenoids were nearly 6 times as likely to develop advanced macular degeneration than those consuming the highest amounts.

Researchers: Seddon, et al.
Published: Journal of the American Medical Association, 1994