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Editors Selection IGR 10-3
Risk Factors: Smoking
Comment by Augusto Azuara Blanco on:
54646 Association of smoking with intraocular pressure in middle-aged and older Japanese residents, Yoshida M; Take S; Ishikawa M et al., Environmental health and preventive medicine, 2014; 19: 100-107
This study by Yoshida et al. reports an association between smoking and increased intraocular pressure (IOP). The authors also tried to find out a potential explanation of such association, in particular whether an increased blood viscosity could explain the findings.
The association between smoking and increased IOP was statistically significant. However, this could not be explained by an increased hematocrit level.
This study has several strengths, including the evaluation of a large number of individuals, and nesting a mechanistic study. The authors must be congratulated also for acknowledging the main limitation of the study, its possible lack of generalizability, as the participants were not necessarily representative of the general population.
Other studies have reported similar findings, and have relevance because smoking is a modifiable factor. In their conclusion, Yoshida et al. Suggest that reduction in smoking may contribute to a decrease in glaucoma blindness. Considering the magnitude of differences in IOP between smokers and non-smokers (approximately 0.3 mmHg) I wonder whether interventions to reduce the number of smokers among the population would have a measurable effect in glaucoma outcomes and blindness. Another positive comment is that, although biased, the study of Yoshida et al. May potentially help the ongoing battle to reduce smoking-related health loss among people with and without glaucoma.
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