SMOKING AND AGE-RELATED MACULAR DEGENERATION - THE POLA STUDY

Objective: To assess the associations between age-related macular dege neration (ARMD) and smoking. Methods: The POLA study is a population-b ased study taking place in the town of Sete, located on the French Med iterranean Sea border. The presence of early and late ARMD was assesse d in 2196 participants on the basis of 50 degrees color fundus photogr aphs using an international classification system. Results: After adju stment for age and sex, current and former smokers showed an increased prevalence of late ARMD (odds ratio [OR] = 3.6, 95% confidence interv al [CI] = 1.1-12.4; OR = 3.2, 95% CI = 1.3-7.7, respectively). An incr eased risk was present in participants who smoked more than 20 pack-ye ars (OR = 3.0, 95% CI = 0.9-9.5 for 20-39 pack-years; OR = 5.2, 95% CI = 2.0-13.6 for 40 pack-years and more). In addition, the risk of late ARMD remained increased until 20 years after cessation of smoking (OR = 9.0, 95% CI = 3.0-27.0 for 1-9 years; OR = 4.0, 95% CI = 1.3-12.0 f or 10-19 years; OR = 1.3, 95% CI = 0.4-4.3 for 20 years and more). Smo king was not significantly associated with early signs of ARMD. Conclu sions: This study further confirms the adverse effect of tobacco on la te ARMD. Former smokers seem to remain at high risk for ARMD.