Exploring the Link Between Smoking and AMD: Facts and Risks

Originally published by Vitreoretinal Consultants of NY.

Age-related macular degeneration (AMD) is a widespread health concern, one only expected to grow in the coming years. As no cure exists, it’s crucial for older adults who are at risk or already living with this condition to take any controllable preventive measures. Chief among these is smoking, found to be the risk factor most closely associated with AMD. Not only do smokers have a higher likelihood of AMD development, but the more you smoke, the higher your risks.

General Risks of Smoking and AMD

Certain risk factors of AMD, such as aging or family history, are beyond your control. With controllable risk factors, reducing or eliminating them may not only reduce the likelihood of having AMD, but also benefit your overall health. Here are some general research findings:

• Smoking is considered the leading manageable AMD risk factor, including all tobacco types, like cigarettes, as well as both regular and secondhand exposure.
• Compared to people who’ve never smoked, current smokers are up to four times more likely to have AMD.
• Smokers may experience AMD up to 10 years earlier than non-smokers, and it’s likely to progress faster and be less responsive to treatment.

AMD and Smoking: The Genetic Connection

There may be a genetic connection, as smokers with specific mutations to a specific gene, HTRA1, have 20 times the likelihood of AMD development than non-smokers. Smokers with this genetic situation comprise up to one-third of all AMD cases. Health experts are considering if genetic testing is needed for those with a family history or already affected. However, quitting smoking may make testing unnecessary, as it can reduce AMD risks for everyone.

Smoking’s Effects on AMD Development and Progression

Whether you’re at risk for age-related macular degeneration or living with it, smoking tobacco takes its toll in different ways.

• Tobacco smoke contains more than 4,500 extremely toxic chemicals, like arsenic and formaldehyde. After traveling through the bloodstream, they can damage parts crucial to vision itself, like the retina, macula, and lens. Delicate tissue, and blood vessels, including the tiny ones in the retina, can be harmed, as well.
• Smoking may reduce the effectiveness of antioxidants, damaging or even killing retina cells. Antioxidants are nutrients that defend against oxidative stress, caused by excess levels of unstable molecules, called free radicals. They can cause cellular damage and are associated with chronic (long-term) conditions, like diabetes and cancer.
• Cigarette smoke, specifically its tar, may contribute to the formation of drusen, which are yellowish deposits of cellular debris that accumulate under the retina; drusen often signifies the earliest signs of AMD.
• Cigarette smoke may lower the amount of oxygen reaching the choroid, a spongy layer of blood vessels and connective tissue on the eye’s back wall. It’s connected to the retinal pigment epithelium (RPE), a pigmented cell layer that absorbs light and limits damaging reflections within the eye.
• Cigarette smoke may activate a part of the immune system called the complement cascade, which may be strongly associated with AMD development.
• Smoking may affect the outcome of certain AMD treatments, like laser therapies.

The Importance of Quitting Smoking for AMD

Faced with the many risks smoking poses for AMD, it’s vital to quit immediately. This may help you to preserve your remaining sight, as research suggests that after 20 years of cessation, AMD development risk was the same as for nonsmokers. Smoking cessation may also be beneficial for people with AMD in a single eye.

Learn How Smoking Can Worsen Age-Related Macular Degeneration

Harmful to begin with, research shows how devastating smoking can be for those with AMD, whether for the eye’s health or the condition itself. To schedule an AMD exam, find a Retina Consultants of America doctor near you.