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Editors Selection IGR 21-1
Risk Factors: Do Smoking and Alcohol increase the Risk of POAG?
Comment by Miriam Kolko on:
111939 Associations of smoking and alcohol consumption with the development of open angle glaucoma: a retrospective cohort study, Mahmoudinezhad G; Nishida T; Weinreb RN et al., BMJ open, 2023; 13: e072163
This retrospective cohort study by Mahmoudinezhad et al. examines the association between smoking, alcohol consumption and the development of open-angle glaucoma in patients suspected of having glaucoma. By analyzing data from 825 eyes of 610 patients over an average of nine years, the study identifies that alcohol consumption significantly increases the risk of developing glaucoma, especially in men and people of African descent. Furthermore, the impact of smoking on glaucoma is more pronounced in older adults.
The results emphasize the importance of taking lifestyle factors into account when assessing risk for glaucoma development, but using only a single self-reported questionnaire to assess alcohol and tobacco use may lead to misclassifications. Changes in participants' smoking and drinking habits over time were not accounted for, which affects the accuracy of the results. Furthermore, unmeasured factors such as physical activity, which has been shown to influence glaucoma susceptibility and visual field loss, may confound the effects of alcohol and smoking on the development of glaucoma.
Unmeasured factors such as physical activity, which has been shown to influence glaucoma susceptibility and visual field loss, may confound the effects of alcohol and smoking on the development of glaucoma
Future research should aim to better define dose-response relationships between alcohol or smoking and glaucoma-related outcomes, including potential non-linear relationships and gene interactions. The study findings of greater glaucoma risk in older smokers should be interpreted with caution due to the limit of statistical significance and issues with multiple testing.
Despite the limitations, as the authors themselves point out, this study has provided an important foundation for understanding the complex associations between lifestyle factors and glaucoma. It emphasizes the need for comprehensive data collection and multifaceted research approaches, ultimately paving the way for more detailed and impactful future studies.
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