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Abstract：
This study aims to assess the association between nicotine replacement therapy (NRT), varenicline, and untreated smoking with the risk of developing eye disorders. We employed a new-user design to investigate the association between NRT use and the incidence of eye disorders by the Taiwan National Health Insurance program. This study included 8416 smokers who received NRT and 8416 smokers who did not receive NRT (control group) matched using propensity scores between 2007 and 2018. After adjustment for relevant factors, a multivariable Cox regression analysis revealed that compared with untreated smokers, NRT use was associated with a significantly reduced risk of macular degeneration (hazard ratio [HR]: 0.34; 95% confidence interval [CI]: 0.13-0.87, P = 0.024). When stratified by dose, short-term NRT use (8-28 defined daily doses) was associated with significantly lower risk of glaucoma (HR: 0.35; 95% CI: 0.16-0.80, P = 0.012) and a trend toward reduced risk of cataract (HR: 0.60; 95% CI: 0.36-1.01, P = 0.053) compared to no treatment. However, these associations were not observed with long-term NRT use. The results of this real-world observational study indicate that NRT use, particularly short-term use, was associated with a lower risk of certain eye disorders compared to no treatment for smoking cessation. Long-term NRT use did not demonstrate the same benefits. Thus, short-term NRT may be a beneficial treatment strategy for reducing the risk of eye disorders in smokers attempting to quit. However, further evidence is required to verify these findings and determine the optimal duration of NRT use.
摘要：
本研究旨在评估尼古丁替代疗法(NRT)与伐尼克林,未经治疗的吸烟有发展为眼部疾病的风险。我们采用了新用户设计，以调查NRT使用与台湾国民健康保险计划的眼疾发病率之间的关联。这项研究包括8416名接受NRT的吸烟者和8416名没有接受NRT的吸烟者（对照组），使用2007年至2018年的倾向评分进行匹配。经相关因素调整后，多变量Cox回归分析显示，与未经治疗的吸烟者相比，使用NRT与黄斑变性的风险显着降低相关（风险比[HR]：0.34;95％置信区间[CI]：0.13-0.87，P=0.024）。当按剂量分层时，与未治疗相比,短期使用NRT(8~28个确定的日剂量)与青光眼风险显著降低(HR:0.35;95%CI:0.16~0.80,P=0.012)和白内障风险降低趋势相关(HR:0.60;95%CI:0.36~1.01,P=0.053).然而,这些关联在长期使用NRT时未观察到.这项真实世界观测研究的结果表明，NRT使用，特别是短期使用，与没有戒烟治疗相比，某些眼部疾病的风险较低。长期使用NRT并未显示出相同的益处。因此，短期NRT可能是降低试图戒烟的吸烟者眼部疾病风险的有益治疗策略.然而,需要进一步的证据来验证这些发现并确定NRT使用的最佳持续时间.
