Tobacco Smoking is Associated to More Severe Stages of Primary Open-Angle Glaucoma Compared to Caffeine Drinking

Abstract

Purpose : Caffeine consumption has been suggested to increase intraocular pressure (IOP) in patients with primary open-angle glaucoma (POAG). On other respect, heavy smoking has been associated with higher odds of glaucoma. Therefore, the objective of this study is to evaluate the association of these two habits and severity of POAG.

Methods : A retrospective review of consecutive medical records of patients with POAG visiting a specialized glaucoma center in Western Mexico from November 2017 to June 2019 was carried. A total of 224 cases were analyzed; 159 cases met inclusion criteria (295 eyes with a diverse distribution of severity. RE: 83 mild, 40 moderate, 24 severe; LE: 78 mild, 49 moderate, 21 severe). Standardized criteria of glaucoma severity, as well as caffeine and tobacco consumption, intensity were taken into consideration. Information on caffeine and tobacco habits was obtained from telephone calls to all available patients. Body mass index, ocular / systemic co-morbities, IOP and several ocular parameters (functional and structural) were variables under study.

Results : Mean visual field index was significantly reduced (P=0.0079) among the right eyes of heavy smokers (59.53 ± 36.07 dB, n=13) as compared to non-smokers/non-heavy smokers (79.5 ± 24.43 dB, n=137). Mean retinal nerve fiber layer thickness in the right eye was also significantly different between the two groups (59.23 ± 10.15 microns vs. 70.46 ± 14.87 microns; P=0.0087). No differences were found between heavy caffeine drinkers and non-drinkers/non-heavy caffeine drinkers in any of the variables analyzed. There was a significant association between the tobacco consumption index and the severity of POAG in the right eye (Spearman’s coefficient, r=0.199, P=0.0162).

Conclusions : Caffeine consumption does not seem to be a relevant risk factor regarding severity of glaucoma. Whereas heavy smoking is associated with more severe functional and structural changes in patients with POAG.

This is a 2020 ARVO Annual Meeting abstract.