Abstract
Purpose :
Although obesity, tobacco and alcohol use have been linked to the development and progression of numerous chronic and degenerative diseases, objective evidence of the association of such aspects of a patient’s social history with glaucoma progression is yet to be determined. The purpose of this study was to investigate the effect of the body mass index (BMI) and history of use of tobacco and alcohol on the rates of retinal nerve fiber loss (RNFL) loss over time in patients with and suspected of glaucoma.
Methods :
This study included 8,424 eyes of 4,480 patients from the Duke Glaucoma Registry. All patients had at least 2 good-quality optical coherency tomography (OCT) tests over a minimum follow-up of 6 months. Self-reported history of alcohol and tobacco consumption was extracted from electronic health records and the mean BMI was calculated for each individual. Linear mixed models were used to determine the effect of each parameter on the rates of change in RNFL over time, with adjustments for sex, race, age at baseline, mean intraocular pressure, central corneal thickness, baseline RNFL, and follow-up time.
Results :
Mean follow-up time was 3.9±2.0 years, with an average of 4.0±1.8 (range: 2 to 13) OCT tests per eye. 41% and 58% of the eyes were from subjects with a history of tobacco or alcohol consumption, respectively, and 71% were classified as overweight or obese (BMI≥25kg/m2). Eyes from subjects with history of tobacco consumption had, on average, 0.072µm/year faster rates of RNFL loss over time than subjects that never used tobacco (P=0.021). Higher BMI, however, had a protective effect on the rates of glaucomatous progression over time (0.005µm/year slower per each 1kg/m2 higher; P=0.047). Alcohol consumption was not significantly associated with rates of RNFL change over time (P=0.130). No significant association was observed between smoking intensity (pack-years) and rates of progression (P=0.757). After adjustment for confounding factors, only BMI remained significantly associated with rates of RNFL loss (ß=0.012; P<0.001).
Conclusions :
Habits of tobacco and alcohol consumption showed no significant effect on the rates of RNFL change in glaucoma. Higher BMI was significantly associated with slower rates of RNFL loss. Future studies should investigate the mechanisms by which BMI may affect structural progression in glaucoma.
This is a 2021 ARVO Annual Meeting abstract.