Skip to main content

Advertisement

SpringerLink
Log in

Smoking complicates the course of non-infectious uveitis

  • Inflammatory Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Background

Data concerning the association of smoking and uveitis are limited. The aim of this study was to evaluate the effect of tobacco smoking on uveitis activity and complications of noninfections uveitis and the need for immunosuppressive therapy.

Methods

We conducted an observational cross-sectional study in 350 patients with noninfectious uveitis. All patients completed a questionnaire concerning smoking habits. Primary outcome measure was uveitis activity in smokers as compared to nonsmokers; secondary outcome measures were need for immunosuppression and uveitis complications.

Results

In all 115 patients (32.9%) were smokers. Smokers had an increased risk for active uveitis (OR 1.8; 95% CI, 1.2–2.9; p = 0.007). Smokers with anterior uveitis had anterior chamber cells more often than nonsmokers (p = 0.008) and required significantly more topical steroid eyedrops (p = 0.002). Uveitis developed at a younger age in smokers than in nonsmokers (p = 0.027). The number of smokers who needed any second-line immunosuppression (p = 0.642) and the number of immunosuppressive agents required (p = 0.794) did not differ from that for nonsmokers. The number of pack-years significantly increased the risk of macular edema (p = 0.020) und cataract (p = 0.022).

Conclusions

Smoking is associated with uveitis activity, leading to increased need for steroid eyedrops and increased incidence of cataract and macular edema. The results highlight the need to encourage uveitis patients to stop or at least to reduce their smoking.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Manguso F, Sanges M, Staiano T, Gargiulo S, Nastro P, Gargano D, Somma P, Mansueto G, Peluso R, Scarpa R, D'Armiento FP, Astarita C, Ayala F, Renda A, Mazzacca G, D'Arienzo A (2004) Cigarette smoking and appendectomy are risk factors for extraintestinal manifestations in ulcerative colitis. Am J Gastroenterol 99:327–334

    Article  PubMed  CAS  Google Scholar 

  2. Pamuk ON, Donmez S, Cakir N (2009) The frequency of smoking in fibromyalgia patients and its association with symptoms. Rheumatol Int 29(11):1311–1314

    Article  PubMed  Google Scholar 

  3. Underner M, Hadjadj S, Beauchant M, Bridoux F, Debiais F, Meurice JC (2008) Effects of smoking on the thyroid gland, digestive system, kidney and bone. Rev Mal Respir 25:1261–1278

    PubMed  CAS  Google Scholar 

  4. Albano SA, Santana-Sahagun E, Weisman MH (2001) Cigarette smoking and rheumatoid arthritis. Semin Arthritis Rheum 31:146–159

    Article  PubMed  CAS  Google Scholar 

  5. Costenbader KH, Feskanich D, Mandl LA, Karlson EW (2006) Smoking intensity, duration, and cessation, and the risk of rheumatoid arthritis in women. Am J Med 119:503–509

    Article  PubMed  Google Scholar 

  6. Hutchinson D, Shepstone L, Moots R, Lear JT, Lynch MP (2001) Heavy cigarette smoking is strongly associated with rheumatoid arthritis (RA), particularly in patients without a family history of RA. Ann Rheum Dis 60:223–227

    Article  PubMed  CAS  Google Scholar 

  7. Saag KG, Cerhan JR, Kolluri S, Ohashi K, Hunninghake GW, Schwartz DA (1997) Cigarette smoking and rheumatoid arthritis severity. Ann Rheum Dis 56:463–469

    Article  PubMed  CAS  Google Scholar 

  8. Stolt P, Bengtsson C, Nordmark B, Lindblad S, Lundberg I, Klareskog L, Alfredsson L (2003) Quantification of the influence of cigarette smoking on rheumatoid arthritis: results from a population based case-control study, using incident cases. Ann Rheum Dis 62:835–841

    Article  PubMed  CAS  Google Scholar 

  9. Sugiyama D, Nishimura K, Tamaki K, Tsuji G, Nakazawa T, Morinobu A, Kumagai S (2009) Impact of smoking as a risk factor for developing rheumatoid arthritis: a meta-analysis of observational studies. Ann Rheum Dis 69(1):70–81

    Article  Google Scholar 

  10. Birtwistle J, Hall K (1996) Does nicotine have beneficial effects in the treatment of certain diseases? Br J Nurs 5:1195–1202

    PubMed  CAS  Google Scholar 

  11. Ritz B, Ascherio A, Checkoway H, Marder KS, Nelson LM, Rocca WA, Ross GW, Strickland D, Van Den Eeden SK, Gorell J (2007) Pooled analysis of tobacco use and risk of Parkinson disease. Arch Neurol 64:990–997

    Article  PubMed  Google Scholar 

  12. Tan EK, Tan C, Fook-Chong SM, Lum SY, Chai A, Chung H, Shen H, Zhao Y, Teoh ML, Yih Y, Pavanni R, Chandran VR, Wong MC (2003) Dose-dependent protective effect of coffee, tea, and smoking in Parkinson's disease: a study in ethnic Chinese. J Neurol Sci 216:163–167

    Article  PubMed  Google Scholar 

  13. Soy M, Erken E, Konca K, Ozbek S (2000) Smoking and Behcet's disease. Clin Rheumatol 19:508–509

    Article  PubMed  CAS  Google Scholar 

  14. van Kooij B, Probst K, Fijnheer R, Roest M, de Loos W, Rothova A (2008) Risk factors for cystoid macular oedema in patients with uveitis. Eye 22:256–260

    Article  PubMed  Google Scholar 

  15. Thorne JE, Daniel E, Jabs DA, Kedhar SR, Peters GB, Dunn JP (2008) Smoking as a risk factor for cystoid macular edema complicating intermediate uveitis. Am J Ophthalmol 145:841–846

    Article  PubMed  Google Scholar 

  16. Lin P, Loh AR, Margolis TP, Acharya NR (2010) Cigarette smoking as a risk factor for uveitis. Ophthalmology 117:585–590

    Article  PubMed  Google Scholar 

  17. Jabs DA, Nussenblatt RB, Rosenbaum JT (2005) Standardization of uveitis nomenclature for reporting clinical data. Results of the First International Workshop. Am J Ophthalmol 140:509–516

    Article  PubMed  Google Scholar 

  18. Galor A, Feuer W, Kempen JH, Kacmaz RO, Liesegang TL, Suhler EB, Foster CS, Jabs DA, Levy-Clarke GA, Nussenblatt RB, Rosenbaum JT, Thorne JE (2010) Adverse effects of smoking on patients with ocular inflammation. Br J Ophthalmol 94:848–853

    Article  PubMed  Google Scholar 

  19. Somerville KW, Logan RF, Edmond M, Langman MJ (1984) Smoking and Crohn's disease. Br Med J (Clin Res Ed) 289:954–956

    Article  CAS  Google Scholar 

  20. Harries AD, Baird A, Rhodes J (1982) Non-smoking: a feature of ulcerative colitis. Br Med J (Clin Res Ed) 284:706

    Article  CAS  Google Scholar 

  21. Flaye DE, Sullivan KN, Cullinan TR, Silver JH, Whitelocke RA (1989) Cataracts and cigarette smoking. The City Eye Study. Eye 3(Pt 4):379–384

    PubMed  Google Scholar 

  22. Grzybowski A (2008) Present knowledge on the effects of smoking tobacco on the eye diseases. Przegl Lek 65:724–727

    PubMed  Google Scholar 

  23. Hiller R, Sperduto RD, Podgor MJ, Wilson PW, Ferris FL III, Colton T, D'Agostino RB, Roseman MJ, Stockman ME, Milton RC (1997) Cigarette smoking and the risk of development of lens opacities. The Framingham studies. Arch Ophthalmol 115:1113–1118

    PubMed  CAS  Google Scholar 

  24. West S, Munoz B, Emmett EA, Taylor HR (1989) Cigarette smoking and risk of nuclear cataracts. Arch Ophthalmol 107:1166–1169

    PubMed  CAS  Google Scholar 

  25. West S, Munoz B, Schein OD, Vitale S, Maguire M, Taylor HR, Bressler NM (1995) Cigarette smoking and risk for progression of nuclear opacities. Arch Ophthalmol 113:1377–1380

    PubMed  CAS  Google Scholar 

  26. Helm CJ, Holland GN (1995) The effects of posterior subtenon injection of triamcinolone acetonide in patients with intermediate uveitis. Am J Ophthalmol 120:55–64

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Ophthalmology at St. Franziskus Hospital, Hohenzollernring 74, 48145, Muenster, Germany

    Martin Roesel, Anne Ruttig, Claudia Schumacher, Carsten Heinz & Arnd Heiligenhaus

  2. University Duisburg-Essen, Essen, Germany

    Carsten Heinz & Arnd Heiligenhaus

Authors
  1. Martin Roesel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anne Ruttig
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Claudia Schumacher
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Carsten Heinz
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Arnd Heiligenhaus
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Martin Roesel.

Additional information

Clinical trial registration number: NCT00827086.

The authors confirm, that they have full control to all the data in the study and agree to allow Graefe’s Archieve for Clinical and Experimental Ophthalmology to review data upon request.

Financial disclosure

The authors state that there are no conflicts of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Roesel, M., Ruttig, A., Schumacher, C. et al. Smoking complicates the course of non-infectious uveitis. Graefes Arch Clin Exp Ophthalmol 249, 903–907 (2011). https://doi.org/10.1007/s00417-010-1597-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-010-1597-1

Keywords

Search

Navigation