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Nonarteritic anterior ischemic optic neuropathy and tobacco smoking.

Hayreh SS, Jonas JB, Zimmerman MB

Department of Ophthalmology, College of Medicine, University of Iowa, Iowa City, Iowa 52242-1091, USA. sohan-hayreh@uiowa.edu

OBJECTIVE: To evaluate whether tobacco smoking may be a risk factor for development of nonarteritic anterior ischemic optic neuropathy (NA-AION). DESIGN: Cohort study. PARTICIPANTS: Six hundred twenty-four consecutive patients with NA-AION who fulfilled our inclusion criteria. METHODS: All patients provided a detailed ocular, medical, and smoking history, and underwent a comprehensive ophthalmic evaluation. For data analysis, patients were divided into current, former, and never smokers. The prevalence for current smoking in the NA-AION patients was compared to the corresponding race-, gender-, age-, and period-matched subgroup of the U.S. population. MAIN OUTCOME MEASURES: Association between NA-AION and tobacco smoking. RESULTS: Of the 624 patients, 369 (59.1%) were men, and mean (+/- standard deviation) age was 61.0+/-12.3 years. Of all the patients, 151 (24.2%) were current smokers, 160 (25.6%) former smokers, and 313 (50.2%) had never smoked. The prevalence of smoking in NA-AION patients was not significantly different from the prevalence in the period-matched U.S. population and the period matched Iowa population. In contrast, the prevalence of diabetes mellitus, ischemic heart disease, arterial hypertension, and cerebrovascular disease in NA-AION patients was significantly higher compared to the prevalence of these chronic conditions in the matched U.S. population (P<0.0001). There was no significant difference in initial visual acuity (P = 0.97) or the amount of initial visual field loss (P = 0.31) among nonsmokers, former smokers, and current smokers. Current smokers had NA-AION in the first eye at a significantly younger age (57.8+/-11.7 years) than former smokers (64.0+/-10.2 years; P<0.0001), and nonsmokers (60.4+/-13.5 years; P = 0.032). Comparison of the distribution of the time to develop NA-AION in the fellow eye showed no significant difference among the 3 groups (log-rank test P = 0.186). CONCLUSIONS: Our study showed no association between NA-AION and tobacco smoking.

Published 2 April 2007 in Ophthalmology, 114(4): 804-9.
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