Smoking as a risk factor for cystoid macular edema complicating intermediate uveitis

PURPOSE: To describe risk factors for the presence of cystoid macular edema (CME) among patients presenting with intermediate uveitis. DESIGN: Cross-sectional study. METHODS: SETTINGS: Single,center, academic practice. STUDY POPULATION: Two hundred and eight patients with intermediate uveitis evaluated from July 1, 1984 through September 30, 2006. PROCEDURES: Clinical and demographic data were entered retrospectively into a database and analyzed. OUTCOME MEASURES: Presence of CME at presentation to our clinic; risk factors for presenting with CME. RESULTS: Of the 208 patients, 74% had bilateral intermediate uveitis, yielding 363 affected eyes. Eighty, nine patients (43%) had CME in at least one eye at the time of presentation to our clinic. After controlling for potentially confounding variables including demographics, duration of disease, active intraocular inflammation, history of diabetes mellitus or hypertension, and presence of epiretinal membrane, actively smoking at presentation was associated with a four-fold increased risk of CME at presentation vs never smoking (odds ratio (OR), 3.90; 95% confidence interval (CI), 1.43, 10.66; P = .008) . Former smoking also appeared to increase the risk of CME at presentation in the multivariate analysis, but the result was of borderline statistical significance (OR, 1.97; 95% CI, 0.99, 3-94; P = .055). After adjusting for confounding, there was a 4% increased risk of CME at presentation for each cigarette smoked per day (OR, 1.04; 95% CI, 1.01, 1.7; P = .005). CONCLUSIONS- CME was a common structural ocular complication observed in our cohort. Current smoking was associated with a dose,dependent increased risk of having CME at the time of presentation to our clinic.