Transcript The effect of antenatal and childhood exposure to maternal
The relation between parental smoking and hypermetropia in children
Yair Morad Yuval Cohen and Lionel Kowal Assaf Herofeh Medical Center, Zrifin, Israel Royal Victorian Eye and Ear Hospital, Melbourne, Australia
Parental smoking inhibits child myopia
Saw et al: less myopia in children of smoking mothers (-0.28 D v -1.38 D) BJO 2004 Stone et al: If one or both parents ever smoked, their children had a lower myopia prevalence (12.4% vs. 25.4%) IOVS 2006
Can parental smoking cause hypermetropia? Maternal smoking associated with moderate hyperopia in six year old but not in 12 year old (N=4321) Ip et al Opthalmology 2008
Aim
To examine the relation between exposure to parental smoking and the development of hypermetropia in children
Design
The database of a Pediatric Ophthalmology Clinic was screened.
1207 children with CR > 0.00D
Only one child from each family was selected
All parents underwent a telephone interview
The questionnaire
Father of mother smoking now? In the past? How many packets per day?
Did mother smoke during pregnancy?
Children of farsighted parents were not included
Results
1007 children included in the study Mean age: 6.2 ± 3.6y (6mo - 17y) Mean spherical equivalent: +3.0±2.3 D (0.0 - +12.75 D)
Mothers 11% smoking today 6.6% smoked in the past Fathers 21% smoking today 11% smoked in the past
Maternal smoking and child’s refraction
P=0.014
P=0.1
Maternal smoking during pregnancy 3 2 1 0 6 5 4 P<0.0001
Non (n=817) 0.2 (n=51) 0.5 (n=50) 0.75 (n=29)
Maternal smoking during pregnancy (PPD)
1 (n=27)
Parental smoking – not significant
Risk to develop esotropia
Mother: non-smoking 70/817 = 8.5% Age: 6.9 ± 3.39
Refraction : +5.2 Mother: smoking 17/122 =14% Age: 8.6
± 3.18
Refraction: +5.4
RR=1.63
Pilot study in Melbourne
N = 142 participants 21% mother smoke; 16% smoked during pregnancy 26% father smoke; 32% smoked during pregnancy 32% have either parent smoking now 38% have parent smoking during pregnancy
Results
Significant association between smoking mother and child hypermetropia (Odd ratio 19.75, CI 95% 1.65-236.51, p 0.02) Smoking mother increases the odds of moderate to severe hyperopia (>+3 D) by nearly 20 folds
Other studies
Stone et al IOVS 2006 N=323 If one or both parents ever smoked, their children had more hyperopic mean refractions (1.83 0.24 vs.0.96 0.27 diopters;
P 0.02)
El-Shazaly et al Ophthalmic & Physiological Optics 2012 N=300 Passive smoking exposure might be associated with hypermetropia
Smoking increases the risk for esotropia
Tasmania, Australia (n=346) Pediatric eye disease and Baltimore pediatric eye disease studies (n= 9970) National Institute of Neurological Disorders and Stroke, Bethesda, Md (n= 39,227)
Possible biochemical mechanism for smoking –refraction interaction Nicotine stimulate dopamine release
Retinal dopamine Eye growth
Nicotinic antagonists injected to old chicks inhibition of ocular growth hyperopic shifting of refraction Stone RA et al IOVS 2001
Conclusions
1.
Maternal smoking increase the risk of hypermetropia in children 2.
The effect of maternal smoking is dose dependent.
3.
Cigarette smoking increase the risk of esotropia in children