Age-related macular degeneration, a progressive eye disease that affects the central portion of the retina, is the leading cause of blindness in the Western world, said study leader Jennifer SL Tan of the University of Sydney.

Tan and colleagues examined 2,454 Australians age 49 and older and asked them to answer a food frequency questionnaire. Study participants had retinal photos taken at five-year and 10-year follow-up exams. An interviewer-administered questionnaire assessed participants’ smoking status.

The findings from the large population-based prospective study added evidence to a possible causal relationship between smoking and the long-term risk of late, but not early, age-related macular degeneration, the authors wrote in the Archives of Ophthalmology.

Current smokers were four times more likely to develop age-related macular degeneration and past smokers were three times as likely to have geographic atrophy -- an advanced form of the disease -- compared to those who had never smoked, the study said.