{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T17:45:28Z","timestamp":1787161528047,"version":"build-2736575974"},"reference-count":72,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Br J Ophthalmol"],"accepted":{"date-parts":[[2022,11,24]]},"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There is accumulating evidence of the associations between age-related eye diseases (AREDs) and smoking or dietary factors. We aimed to provide an umbrella review of the published literature pertaining to smoking or dietary intake as risk factors for major AREDs including cataract, glaucoma, age-related macular degeneration (AMD) and diabetic retinopathy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We searched for pertinent systematic reviews or meta-analyses in PubMed and Web of Science until 16 April 2022. We reperformed the meta-analysis of each association using random effects models. The heterogeneity and 95% prediction interval were calculated. The presence of small-study effect or excess significance bias was also assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 64 associations from 25 meta-analyses and 41 associations from 10 qualitative systematic reviews were evaluated. There was convincing (class I) evidence for only one association, namely current smoking and cataract. Two factors had highly suggestive (class II) evidence, namely ever smoking associated with cataract and fish consumption associated with AMD. We also found suggestive (class III) evidence for associations between the dietary intake of omega-3 polyunsaturated fatty acid, lutein, zeaxanthin, vitamin C and the risk of cataract.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Smoking as a risk factor for cataract was the most robust association we identified. We also identified several dietary elements associated with AREDs. Large prospective studies are warranted to further examine the associations discussed in this review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD42022339082.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bjo-2022-322325","type":"journal-article","created":{"date-parts":[[2022,12,8]],"date-time":"2022-12-08T13:20:15Z","timestamp":1670505615000},"page":"51-57","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":25,"title":["Smoking, dietary factors and major age-related eye disorders: an umbrella review of systematic reviews and meta-analyses"],"prefix":"10.1136","volume":"108","author":[{"given":"Jia-Yan","family":"Kai","sequence":"first","affiliation":[{"name":"School of Public Health, Medical College of Soochow University, Suzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6374-7334","authenticated-orcid":false,"given":"Miao","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Peking University People's Hospital, Beijing, China"},{"name":"Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0800-4308","authenticated-orcid":false,"given":"Dan-Lin","family":"Li","sequence":"additional","affiliation":[{"name":"School of Public Health, Medical College of Soochow University, Suzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ke-Yao","family":"Zhu","sequence":"additional","affiliation":[{"name":"Pasteurien College of Soochow University, Suzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Wu","sequence":"additional","affiliation":[{"name":"School of Public Health, Medical College of Soochow University, Suzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiao-Feng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Dushu Lake Hospital Affiliated to Soochow University, Suzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3362-4613","authenticated-orcid":false,"given":"Chen-Wei","family":"Pan","sequence":"additional","affiliation":[{"name":"School of Public Health, Medical College of Soochow University, Suzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,12,8]]},"reference":[{"key":"2026011304301019000_108.1.51.1","doi-asserted-by":"crossref","first-page":"e888","DOI":"10.1016\/S2214-109X(17)30293-0","article-title":"Magnitude, temporal trends, and projections of the global prevalence of blindness and distance and near vision impairment: a systematic review and meta-analysis","volume":"5","author":"Bourne","year":"2017","journal-title":"Lancet Glob Health"},{"key":"2026011304301019000_108.1.51.2","unstructured":"Abyu GY . 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