Smoking and Risk of Uveitis: A Systematic Review and Meta-Analysis
Abstract
Purpose Uveitis is a relatively common eye condition that can lead to substantial symptoms and visual impairment. Identifying modifiable risk factors is essential for effective prevention and management. This systematic review and meta-analysis aimed to assess the causal role of smoking in uveitis by summarizing existing evidence on its impact on pathogenesis, disease progression, and treatment outcomes.Methods A comprehensive search was conducted in Ovid MEDLINE and Embase in December 2024. Studies were eligible if they included an ophthalmologist-confirmed diagnosis of uveitis and reported on smoking exposure. Exclusion criteria were pediatric populations, case reports/series, interventional studies, and studies involving patients with systemic disease to minimize confounding. The review followed PRISMA guidelines and a pre-registered PROSPERO protocol (CRD42025641517). Risk of bias was assessed using Joanna Briggs Institute tools. Data were extracted by one reviewer and verified by another. Meta-analyses were performed using RevMan, with heterogeneity evaluated by I2. Certainty of evidence was assessed using GRADE methodology.Results Of 892 articles screened, seven met inclusion criteria: four retrospective case-control studies, one retrospective cohort study, and two cross-sectional studies. The pooled odds ratio (OR) for the association between smoking and uveitis was 1.97 (95% CI, 1.71–2.27) across 1557 individuals with uveitis and 4293 controls. The effect was…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 1,557 participants or records.
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