Smoking Intensity is Associated with Progressive Optic Nerve Head Vessel Density loss in Glaucoma

Takashi Nishida; Robert N Weinreb; Natchada Tansuebchueasai; Jo-Hsuan Wu; Leo Meller; Golnoush Mahmoudinezhad; Gopikasree Gunasegaran; Mohsen Adelpour; Sasan Moghimi

doi:10.1097/IJG.0000000000002410

Smoking Intensity is Associated with Progressive Optic Nerve Head Vessel Density loss in Glaucoma

J Glaucoma. 2024 Apr 23. doi: 10.1097/IJG.0000000000002410. Online ahead of print.

Authors

Takashi Nishida¹, Robert N Weinreb¹, Natchada Tansuebchueasai^{1

2}, Jo-Hsuan Wu¹, Leo Meller¹, Golnoush Mahmoudinezhad¹, Gopikasree Gunasegaran¹, Mohsen Adelpour¹, Sasan Moghimi¹

Affiliations

¹ Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, United States.
² Department of Ophthalmology, Faculty of Medicine, Prince of Songkla University, Songkhla, Thailand.

PMID: 38647412
DOI: 10.1097/IJG.0000000000002410

Abstract

Purpose: To investigate the relationship of smoking and smoking intensity, with the rate of optic nerve head (ONH) whole image capillary density (wiCD) loss in primary open angle glaucoma (POAG) and glaucoma suspect patients.

Methods: In this longitudinal study, POAG patients who had at least 2 years of follow-up and optical coherence tomography angiography (OCTA) performed at a minimum of 4 visits were selected for study. The smoking intensity was calculated as the pack-year at the baseline OCTA. Univariable and multivariable linear mixed models were used to determine the effect of each parameter on the rates of wiCD loss over time. Nonlinear least-squares estimation with piecewise regression model was used to investigate the cutoff point for the relationship between wiCD loss and smoking intensity.

Results: 164 eyes (69 glaucoma suspect and 95 POAG) of 110 patients were included with a mean (95% CI) follow-up of 4.0 (3.9 to 4.1) years. Of the 110 patients, 50 (45.5%) had a reported history of smoking. Greater smoking intensity was associated with faster wiCD loss (-0.11 (-0.23 to 0.00)) %/year per 10 pack-year higher; P=0.048) after adjusting for covariates. The wiCD thinning became significantly faster when smoking intensity was greater than 22.2 pack-years. Smoking had no effect on the rate of wiCD thinning in patients who smoked < 22.2 pack-years during their lifetime.

Conclusions: A history of greater smoking consumption was associated with faster vessel density loss, suggesting smoking intensity as a potential risk factor for glaucoma.