Cigarette smoking and male sex are risk factors for ocular sarcoidosis

Cigarette smoking and male sex are significant risk factors for developing ocular sarcoidosis, according to a new study presented at the 2014 American Thoracic Society International Conference.

Sarcoidosis is a disease in which inflammation produces tiny lumps of cells (called granulomas) in organs throughout the body, most often in the lungs, but also in the eyes, lymph nodes, or skin. Ocular sarcoidosis, which can lead to blindness, affects 25-50% of sarcoidosis patients.

"Risk factors for ocular sarcoidosis have not been well studied," said lead author Adam Janot, MD, of the Virginia Commonwealth University School of Medicine in Richmond. "Accordingly, we reviewed the cases of 109 patients with biopsy-proven sarcoidosis and identified independent risk factors for developing ocular morbidity."

Of the 109 patients, 21 had ocular sarcoidosis. A significantly higher percentage of patients with ocular sarcoidosis were smokers (71.4% vs 42.0%, p=0.027) and were male (57.1% vs 26.1%, p=0.009). Median duration of sarcoidosis was 10 years among patients with ocular sarcoidosis and 4 years among those without (p=0.031).

In analyses adjusting for age, race, sex, and other factors, tobacco exposure was associated with a greater than 5-fold risk of developing ocular sarcoidosis (odds ratio 5.24, p=0.007, 95% CI 1.58-17.41) and male sex was associated with a greater than 7-fold risk (odds ratio 7.48, p=0.002, 95% CI 2.152-26.006). Disease duration was no longer significantly associated with developing ocular sarcoidosis in the multivariate analysis. "Our study is the first to correlate smoking and male sex as risk factors for developing ocular manifestations of sarcoidosis," said Dr. Janot. "If confirmed in other studies, this information may give some insight into the pathology of the disease, can be useful in guiding treatment, and it adds ocular sarcoidosis to the numerous adverse health consequences of tobacco use."