Published in Archives

One more reason not to smoke. — Weekly Glance

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WHAT YOUR PATIENT  MIGHT ASK YOU.
Does smoking affect glaucoma?

A study published in the Journal of Glaucoma found smoking linked to decreased optic nerve vessel density.

Some background.

Decreased ocular perfusion pressure has been associated with an increase in glaucoma prevalence, incidence, and worsening symptoms, suggesting that microvascular abnormalities may contribute to the pathophysiology of the disease. Cigarette smoking directly alters blood flow in the choriocapillaris.

Moreover, smoking may cause vasoconstriction of the episcleral veins. It's possible that reduced optic disc blood flow in smokers contributes to further retinal nerve fiber injury and susceptibility to progression of glaucoma in eyes with the disease.

The study details.

A total of 432 eyes of 271 patients with glaucoma were included. A history of tobacco consumption was reported in 38% of patients. Among smokers, mean smoking intensity was 12.8 packs/year. After adjusting for age, glaucoma severity and other confounders, each 10 pack/year increase in smoking intensity was associated with 0.54% lower capillary density.

The take home.

Higher intensity of smoking was significantly associated with decreased optic nerve head microvasculature, supporting the value of obtaining an accurate history of smoking and, particularly, the intensity of smoking, as it may help in screening and monitoring glaucoma to stratify patients with open-angle glaucoma. (via)