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The Framingham Studies

Rita Hiller, MS; Robert D. Sperduto, MD; Marvin J. Podgor, PhD; Peter W. F. Wilson, MD; Frederick L. Ferris III, MD; Theodore Colton, ScD; Ralph B. D'Agostino, PhD; Mark J. Roseman, OD; Margaret E. Stockman; Roy C. Milton, PhD

Arch Ophthalmol. 1997;115(9):1113-1118.

Abstract
Objective
To examine the association between cigarette smoking and the incidence of nuclear and non-nuclear lens opacities in members of the Framingham Eye Study Cohort.

Participants and Methods
Eye examinations were conducted on surviving members of the Framingham Heart Study Cohort from 1973 to 1975 (Framingham Eye Study I) and again from 1986 to 1989 (Framingham Eye Study II). Smoking data, collected biennially since 1948 in the Heart Study, were used to examine the relationship between cigarette smoking and the incidence of lens opacities. Two thousand six hundred seventy-five persons were examined in the Framingham Eye Study I. Our analysis included 660 persons, aged 52 to 80 years, who were free of lens opacities at the first eye examination.

Results
During the approximately 12.5 years between eye examinations, lens opacities developed in a total of 381 persons, with nuclear opacities constituting the most frequent type. In logistic regression analyses that controlled for age, sex, education, and diabetes, a significant positive association with increasing duration of smoking and number of cigarettes smoked daily was found for nuclear lens opacities, alone or in combination (test for trend, P.002), but not for nonnuclear opacities (test for trend, P=.62). Among the heavier smokers (persons who smoked 20 cigarettes per day according to 6 or more biennial Framingham Heart Study examinations), 77% were still smoking at the time of the first eye examination. Persons who smoked 20 or more cigarettes per day at the time of the first eye examination were at substantially increased risk for the development of nuclear opacities than nonsmokers (odds ratio, 2.84; 95% confidence interval, 1.46-5.51). There was no apparent excess risk for persons with nonnuclear lens opacities (odds ratio, 1.42; 95% confidence interval, 0.65-3.07).

Conclusion
This study provides further evidence that cigarette smokers have an increased risk of developing nuclear lens opacities. The risk was greatest for heavier smokers, who tended to be current smokers and who smoked more cigarettes and for a longer duration.

Author Affiliations
From the National Eye Institute, Bethesda, Md (Ms Hiller and Drs Sperduto, Podgor, Ferris, and Milton); the National Heart, Lung, and Blood Institute, Framingham, Mass (Dr Wilson); the Departments of Epidemiology and Biostatistics (Drs Colton and Roseman and Ms Stockman) and Mathematics (Dr D'Agostino), Boston University, Boston, Mass; and the EMMES Corporation, Potomac, Md (Dr Milton).

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