Previous smokers in this study who quit within the last 25 years had greater visual field progression. Photo: Reza Mehrad on  Unsplash.

Recent findings showed that after more than 25 years of smoking cessation, the risk of visual field progression in former heavy smokers is similar to those who had never smoked. This research suggests that long-term smoking cessation may be linked with lower visual field progression among glaucoma patients.

The study enrolled primary open-angle glaucoma patients with a minimum of three years of follow-up and five visual fields. The researchers used linear mixed models to explore the effects of smoking on the rates of 24-2 visual field mean deviation loss after adjusting for confounding factors.

Over the mean follow-up of 12.4 years, the analysis included 511 eyes of 354 patients with a mean baseline age of 62.3 years. Of those, 168 (59.8%) patients were smokers. The study authors reported that smoking intensity was associated with faster visual field loss in smokers. Additionally, the data showed that heavy smokers (≥20 pack-years) who had quit less than 25 years before had significantly greater odds of visual field progression when compared with those who had never smoked.

No significant difference in odds of visual field progression was observed among heavy smokers who had quit smoking more than 25 years ago vs. non-smokers. Kaplan-Meier analysis revealed a significantly higher proportion of visual field progression in heavy smokers who quit less than 25 years ago compared with their counterparts who quit more than 25 years prior.

“This study demonstrated that long-term smoking cessation may reduce visual field progression among heavy smokers after 25 years. Current research supports that modifiable factors other than IOP may be related to glaucoma progression,” the study authors wrote in their Journal of Glaucoma paper. “Among heavy smokers, relative to those individuals who never smoked, former smokers’ risk remained significantly elevated within 25 years after smoking cessation.”

Based on these findings, the researchers concluded that smoking cessation is warranted among patients with glaucoma. Their study also highlights the importance of developing effective screening in the clinical setting, particularly for high-risk patients.

Mahmoudinezhad G, Nishida T, Weinreb RN, et al. Smoking cessation may reduce risk of visual field progression in heavy smokers. J Glaucoma. August 2, 2022. [Epub ahead of print].