Study on Smoking and Choroidal Microvasculature Dropout in Glaucoma

A recent study published by BMJ Open Ophthalmology clarified the effect of smoking on choroidal microvasculature dropout (MvD) in glaucoma patients. Based on a cross-sectional investigation, the results indicate that higher smoking intensity is linked to larger MvD regions, especially in individuals with more severe forms of the disease.

Undertaken at a tertiary glaucoma center, 223 eyes from 163 patients with primary open-angle glaucoma were included in this study. As part of the Diagnostic Innovations in Glaucoma Study, researchers used optical coherence tomography angiography and sent out smoking questionnaires to collect data.

The study revealed that smoking history was associated with MvD in 51.4% of eyes, while non-smokers exhibited MvD in 44.4% of cases. Though the overall prevalence of MvD didn't significantly differ between the two groups (p=0.389), some important distinctions were observed.

• Compared to non-smokers, smokers displayed larger MvD areas (p=0.068) and wider angular circumferences (p=0.046).
• Importantly, a multivariable model showed that smoking intensity had a significant link to MvD area (0.30; 95% CI 0.01 to 0.60) for each 0.01 mm² per 10 pack-years (p=0.044).

However, the impact of smoking on MvD wasn't uniform across glaucoma severity levels. In individuals with moderate to severe glaucoma (MD < −6), smoking intensity was significantly associated with larger MvD areas (0.47; 95% CI 0.11 to 0.83) for each 0.01 mm² per 10 pack-years (p=0.011). This effect was not observed in individuals with early glaucoma (MD ≥ −6), where the association was not significant (−0.08; 95% CI −0.26 to 0.11, p=0.401).

These findings raise concerns about the potential impact of smoking on the eye health of glaucoma patients. The study suggests that smoking, particularly its intensity, may contribute to larger MvD areas, especially in individuals with moderate to severe forms of the condition. The study highlights the importance of addressing smoking cessation in glaucoma management and underscores the need for further research into the relationship between smoking and eye health. Understanding these connections can aid in the development of targeted interventions to improve the eye health and overall well-being of glaucoma patients, especially those who smoke.

Reference

Nishida, T., Micheletti, E., Latif, K., Du, K. H., Weinreb, R. N., & Moghimi, S. (2023). Impact of smoking on choroidal microvasculature dropout in glaucoma: a cross-sectional study. In BMJ Open Ophthalmology (Vol. 8, Issue 1, p. e001421). BMJ. https://doi.org/10.1136/bmjophth-2023-001421