11/07/2022
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Impact of Smoking on VF Progression in a Long-term Clinical Follow-up
Researchers investigated the effect of smoking on the rates of progressive visual field damage over time in glaucoma, as part of a retrospective cohort study.
A total of 511 eyes of 354 patients with glaucoma followed from multicenter glaucoma registries were included in this longitudinal study: 354 primary open-angle glaucoma patients with a minimum of three years follow-up, and five VF tests from the Diagnostic Innovations in Glaucoma Study (DIGS) and African Descent and Glaucoma Evaluation Study (ADAGES).
Univariable and multivariable linear mixed models were used to investigate the effects of smoking on the rates of 24-2 VF mean deviation loss. VF progression was defined using pointwise linear and significant negative VF MD loss. Logistic regression was used to identify baseline factors and whether different levels of smoking intensity were associated with VF progression. Kaplan-Meier survival analysis and the log-rank test were used to compare the cumulative risk ratio of progression between smoker and never-smoker groups. Main outcome measures included VF progression.
A total of 511 eyes of 354 patients were included over the median follow-up of 12.5 years. Median baseline age was 64.8 years. Here are some of the findings:
• Of 354 patients, 124 (35 percent) were of African ethnicity, 168 (59.8 percent) reported a history of smoking and 149 (42.1 percent) reported a history of alcohol consumption.
• In a multivariable model, higher smoking intensity was associated with faster VF loss (coefficient -0.05; CI, -0.08 to -0.01 dB/year per 10 pack-years; p=0.010).
• Developing VF progression in eyes of heavy smokers (≥20 pack-years) was 2.2 times greater than in eyes of patients without smoking history (OR=2.21; CI, 1.02 to 4.76; p=0.044).
• Statistically significant differences were found between heavy smokers (≥20 packs-year) and never-smokers by Kaplan-Meier analysis (log rank test, p=0.011).
Researchers found that heavy smokers were more likely to have visual field loss in eyes with glaucoma and that levels of smoking may be a significant predictor for glaucoma progression. They suggested this information can be used for clinically relevant to***co prevention and intervention messages.
SOURCE: Mahmoudinezhad G, Nishida T, Weinreb RN, et al. Impact of smoking on visual field progression in a long-term clinical follow-up. Ophthalmol 2022; June 22. [Epub ahead of print].