Cessation of smoking may reduce visual field progression among heavy smokers with glaucoma

The earlier a person quits smoking the more likely the optic nerve be spared from damage.

A study was conducted to investigate the effect of smoking cessation on visual field (VF) progression in glaucoma.

Primary open-angle glaucoma patients with a minimum of 3 years follow-up and 5 VFs were included. Linear mixed models were used to investigate the effects of smoking on the rates of 24-2 VF mean deviation loss after adjusting for confounding factors. Cox proportional hazard regression was used to identify whether different levels of smoking intensity were associated with VF progression with respect to different duration of quitting.

Results:

• Five hundred eleven eyes of 354 patients were included over the mean follow-up of 12.4 years. Mean baseline age (95% confidence interval) was 62.3 (61.2, 63.4) years.
• One hundred forty-nine (42.1%) patients were smokers. In a multivariable model, smoking intensity was associated with faster VF loss among smokers.
• Heavy smokers (≥20 pack-years) who had quit ˂25 years prior had significantly greater odds of VF progression compared with never smokers
• There was no significant difference in odds of VF progression in heavy smokers who had quit smoking more than 25 years compared with never smokers
• A significantly higher proportion of VF progression was found in heavy smokers who quit < 25 years compared with heavy smokers who quit ≥25 years by Kaplan-Meier analysis

After ≥25 years of smoking cessation, the risk of VF progression in former heavy smokers becomes similar to never smokers. Long-term smoking cessation may be associated with lower VF progression in glaucoma patients.

Reference:

Mahmoudinezhad, Golnoush MD, MPH*; Nishida, Takashi MD, PhD*; Weinreb, Robert N. MD*; Baxter, Sally L. MD, MSc, MD*,†; Walker, Evan MSc*; Eslani, Medi MD*; Liebmann, Jeffrey M. MD‡; Girkin, Christopher A. MD, MSPH§; Moghimi, Sasan MD*. Smoking Cessation May Reduce Risk of Visual Field Progression in Heavy Smokers. Journal of Glaucoma: October 2022 - Volume 31 - Issue 10 - p 796-803 doi: 10.1097/IJG.0000000000002092