June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Impact of Smoking on Visual Field Progression
Author Affiliations & Notes
  • Golnoush Mahmoudinezhad
    Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, San Diego, California, United States
  • Takashi Nishida
    Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, San Diego, California, United States
  • Robert N Weinreb
    Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, San Diego, California, United States
  • Sally Baxter
    Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, San Diego, California, United States
  • Medi Eslani
    Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, San Diego, California, United States
  • Jeffrey M Liebmann
    Bernard and Shirlee Brown Glaucoma Research Laboratory, Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Medical Center, New York, New York, United States
  • Massimo A. Fazio
    School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Christopher A Girkin
    School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, United States
  • Linda Zangwill
    Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, San Diego, California, United States
  • Sasan Moghimi
    Hamilton Glaucoma Center, Shiley Eye Institute, Viterbi Family Department of Ophthalmology, San Diego, California, United States
  • Footnotes
    Commercial Relationships   Golnoush Mahmoudinezhad None; Takashi Nishida None; Robert Weinreb C: Aerie Pharmaceuticals, Allergan, Equinox, Eyenovia, Nicox, Topcon ; F: Heidelberg Engineering, Carl Zeiss Meditec, Konan Medical, Optovue, Centervue, Bausch&Lomb, Topcon; P: Toromedes, Carl Zeiss Meditec, Topcon (Dec 2021), Code F (Financial Support); Sally Baxter None; Medi Eslani None; Jeffrey Liebmann C: Alcon, Allergan, Bausch & Lomb, Carl Zeiss Meditec, Heidelberg Engineering, Reichert, Valeant Pharmaceuticals; F: Bausch & Lomb, Carl Zeiss Meditec, Heidelberg Engineering, National Eye Institute, Novartis, Optovue, Reichert Technologies, Research to Prevent Blindness (updated Nov 2020), Code F (Financial Support); Massimo Fazio F: National Eye Institute, EyeSight Foundation of Alabama, Research to Prevent Blindness, Heidelberg Engineering, GmbH, Code F (Financial Support); Christopher Girkin F: National Eye Institute, EyeSight Foundation of Alabama, Research to Prevent Blindness, Heidelberg Engineering, GmbH, Code F (Financial Support); Linda Zangwill C: Abbvie Inc. Digitial Diagnostics F: National Eye Institute, Carl Zeiss Meditec Inc., Heidelberg Engineering GmbH, Optovue Inc., Topcon Medical Systems Inc. P: Zeiss Meditec (updated Dec 2021), Code F (Financial Support); Sasan Moghimi None
  • Footnotes
    Support  National Eye Institute R01EY029058, R01EY11008, R01EY19869, R01EY027510, R01EY026574, EY018926 P30EY022589, National Institutes of Health DP5OD029610, Unrestricted grants from Research to Prevent Blindness (New York, NY), EyeSight Foundation of Alabama; National Eye Institute; Research to Prevent Blindness, Tobacco-Related Disease Research Program T31IP1511
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 2266. doi:
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    • Get Citation

      Golnoush Mahmoudinezhad, Takashi Nishida, Robert N Weinreb, Sally Baxter, Medi Eslani, Jeffrey M Liebmann, Massimo A. Fazio, Christopher A Girkin, Linda Zangwill, Sasan Moghimi; Impact of Smoking on Visual Field Progression. Invest. Ophthalmol. Vis. Sci. 2022;63(7):2266.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To investigate the effect of smoking on the rates of progressive visual field damage over time in glaucoma.

Methods : In this longitudinal study, 354 primary open-angle glaucoma (POAG) patients with a minimum of 3 years follow-up and 5 visual fields (VF) tests were enrolled from the Diagnostic Innovations in Glaucoma Study (DIGS) and the 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 after adjusting for confounding factors such as alcohol consumption and Body Mass Index. VF progression was defined using pointwise linear regression (three test locations having a significant regression slope (p<0.01) of ≤-1dB per year). Logistic regression was used to identify whether different levels of smoking intensity were associated with VF progression. Kaplan-Meier curve and the log-rank test were used to compare the cumulative risk ratio of progression between different smoking intensity categories.

Results : A total of 511 eyes of 354 patients with glaucoma followed from multicenter glaucoma registries were included over the mean follow-up of 12.4 years. Mean baseline age was 62.3 years; 124 (35%) were African ethnicity. Of the 354 patients, 168 (59.8%) and 149 (42.1%) had reported a history of smoking or alcohol consumption, respectively. 39 (11%) were heavy smokers. In a multivariable model, higher smoking intensity was associated with faster VF loss (coefficient -0.05 (-0.08,-0.01)dB/year per 10 pack-years, P=0.01). Developing VF progression in eyes of heavy smokers (>20 pack-years) was 2.2 times greater than in eyes of non-smokers after adjusting for confounding factors (OR=2.21; 95% CI: 1.02,4.76; P=0.04), Figure 1. A significantly higher proportion of progressing eyes were found in heavy smokers compared to non-smokers by Kaplan-Meier analysis (log-rank test, P<0.01), Figure 2.

Conclusions : Heavy smokers are more likely to have VF loss in eyes with glaucoma. The prospective longitudinal design of this study supports the hypothesis that levels of smoking may be associated with glaucoma progression. Additionally, this information can be used for clinically relevant tobacco prevention and intervention messages.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

 

The proportion of VF progressors for different smoking intensity categories.

The proportion of VF progressors for different smoking intensity categories.

 

Cumulative probablity of visual field progression in glaucoma eyes in different smoking intensity categories.

Cumulative probablity of visual field progression in glaucoma eyes in different smoking intensity categories.

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