Smoking Cessation May Reduce Risk of Visual Field Progression in Heavy Smokers. Issue 10 (2nd August 2022)

• Record Type: Journal Article
• Authors: Mahmoudinezhad, Golnoush; Nishida, Takashi; Weinreb, Robert N.; Baxter, Sally L.; Walker, Evan; Eslani, Medi; Liebmann, Jeffrey M.; Girkin, Christopher A.; Moghimi, Sasan
• Is Part Of: Journal of glaucoma. Volume 31:Issue 10(2022)
• Page Start: 796
• Page End: 803
• Publication Date: 2022-08-02
• Subjects: primary open angle glaucoma -- visual field -- smoking -- cessation; Glaucoma -- Periodicals; 617.741005
• DOI: 10.1097/IJG.0000000000002092
• Languages: English
• ISSNs: 1057-0829

Abstract

Abstract : Précis: The earlier a person quits smoking the more likely is the optic nerve be spared from damage. Purpose: To investigate the effect of smoking cessation on visual field (VF) progression in glaucoma. Methods: 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 (−0.06, 95% confidence interval (−0.10, −0.01) dB/year per 10 pack-years, P =0.01) among smokers. Heavy smokers (≥20 pack-years) who had quit ˂25 years prior had significantly greater odds of VF progression compared with never smokers (odds ratio=2.49 (1.01, 6.08); P =0.046). 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 ( P =0.43). 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 ( P =<0.001). Conclusions: 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.