DOI: 10.4103/azmj.azmj_9_26 ISSN: 1687-1693

Effect of smoking on macula, choroidal vasculature, and retinal nerve fiber layer thickness

Esraa Fathy M. Eltayeb, Mohamed E. Dardyr, Mohamed A. Salih
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Background and aim

Smoking is a major modifiable risk factor associated with systemic and ocular vascular dysfunction. Chronic nicotine exposure may induce structural and microvascular changes in the retina and choroid, which can be quantitatively evaluated using optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA). We aimed to evaluate the effect of chronic smoking on the macula, choroidal vasculature, and peripapillary retinal nerve fiber layer (RNFL) thickness using swept-source OCT (SS-OCT) and OCTA.

Patients and methods

This case–control study included 200 eyes of 100 participants examined at Al-Azhar University Hospital, Assiut, Egypt, between January and December 2023. Participants were divided into a smoker group (100 eyes of 50 chronic smokers) and a control group (100 eyes of 50 nonsmokers).

Results

The mean age was 35.3±8.1 years for smokers and 32.2±8.9 years for nonsmokers ( P >0.05). All smokers were male, whereas 44% of nonsmokers were male ( P <0.001). Central macular thickness and choroidal thickness showed no significant difference. Superficial macular vessel density was higher in smokers at the superior and nasal parafovea ( P <0.05). Peripapillary RNFL thickness was reduced in smokers in the inferior quadrant and total thickness. A significant negative correlation was found between smoking index and RNFL thickness at the superior, inferior, nasal, and total measurements.

Conclusion

Chronic smoking is associated with alterations in superficial macular microvasculature and significant thinning of peripapillary RNFL, while central macular thickness and choroidal thickness were unaffected.

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