More research needed on smoking, development of primary open-angle glaucoma

The causal relationship between tobacco smoking and development of primary open-angle glaucoma has not yet been established in existing literature, but smoking should still be cautioned against because of evidence linking it to other ocular diseases.

Richard Edwards, MPH, MD, and colleagues conducted a systemic review of 11 papers — one prospective cohort study, one pooled analysis of two prospective cohort studies and nine case-controlled studies — that examined epidemiologic evidence of a causal association between tobacco smoking and primary open-angle glaucoma. The results were published in the October/November issue of Journal of Glaucoma.

The overall methodologic quality of most of the studies was determined to be poor. Both the prospective study and pooled analysis found no association between smoking and primary open-angle glaucoma, while a significant association between smoking and glaucoma was found in only two case-controlled studies.

"Given the limited evidence from high-quality studies, and the possibility that flaws in many of the studies reviewed biased the results toward the null, further high-quality research to confirm our conclusions is needed," the study authors said.