Researchers caution clinicians to beware of the increased risk of uveitis among patients with a history of e-cigarette use. The link is thought to be related to the increased levels of oxidative stress-related proteins found in the sputum of e-cigarette users, a finding that has been previously implicated in uveitis development. Photo: Getty Images. Click image to enlarge.

Studies have identified increased levels of proteins associated with oxidative stress in the sputum of e-cigarette users. These proteins have been linked to the onset of uveitis, suggesting that those who vape nicotine may be more susceptible to developing this condition. A new study in Ophthalmology that investigated the potential association found that there was indeed an elevated risk of uveitis among this patient cohort.

The study authors used the TriNetX database, comprising data from more than one hundred million patients across various regions, to identify patients ≥18 years old with and without a recent history of e-cigarette usage. Their analysis included 419,325 e-cigarette users and 419,325 comparators, with a similar racial distribution between the two groups (including patients of Asian, Black or African and white ethnicities). The primary outcome was incidence of newly diagnosed uveitis.

The results showed that e-cigarette users demonstrated a heightened risk of developing uveitis when compared to non-users, with a hazard ratio (HR) of 2.53. Age stratification in subgroup analyses revealed a heightened risk for uveitis among e-cigarette users in the age groups of 18 to 39 years (HR: 2.59), 40 to 64 years (HR: 2.20) and those aged 65 and above (HR: 3.15). Additionally, this risk persisted throughout four years of follow-up, indicating the effect of e-cigarette use on uveitis risk is both short- and long-term.

Traditional cigarette use was also found to increase uveitis risk (HR: 1.28), but not as significantly as e-cigarette use. Additionally, patients with a history of both e-cigarette and cigarette use had a higher uveitis risk than those only using traditional cigarettes.

These findings warrant further investigation, especially considering only case reports have previously documented an association between uveitis and e-cigarette use, the researchers argued. They concluded in their Ophthalmology paper that “clinicians caring for patients with e-cigarette history should be aware of the potentially increased risk of new-onset uveitis.”