Effect of smoking in the vascularization of the retina through optical coherence tomography angiography

Abstract

INTRODUCTION Tobacco use is a risk factor for numerous respiratory, cardiovascular and tumor
diseases, mainly, but it is also a risk factor for eye disorders.
OBJETIVE: To compare by means of angiography-optical coherence tomography (OC-A) the density of
the vessels and the perfusion density of the superficial retina and the foveal avascular zone (FAZ) of the
retina between a group of smoker patients and a group of non-smoker patients smokers.
MATERIAL AND METHODS: Prospective, analytical, observational and cross-sectional study. 100 eyes
of people of both sexes between 20 and 70 years’ old who attended the Ophthalmological Institute of
Córdoba in a period of one year were studied. Healthy smokers and non-smokers were included, who signed
informed consent, excluding those with some pre-existing systemic comorbidity or with high ametropia.
They underwent a complete ophthalmological evaluation and an angiography using OCT-HD Cirrus Model
5000, recording the values of vessel density (mm/mm2) and perfusion density of the superficial retina (%)
and the area of the foveal avascular zone (mm2) in an analysis field of 3 x 3 mm2. As statistical analysis,
the Mann-Whitney Test and the Kruskal-Wallis Test were used, considering p<0.05 as statistically
significant. The work was approved by the Research Ethics Committee of Sanatorio Allende. Results: 100
eyes were analyzed, 50% were smokers (50) and 50% were non-smokers (50). 77% (77) were women and
23% (23) men. The predominant age range was 50-55 years. No significant results (p>0.5) were obtained
when comparing between smokers and non-smokers the density of central vessels (9.89 ±2.80 vs 9.88
±3.76), the density of peripheral vessels (21.16 ±1.57 vs 21.01 ±2.54), the measurement of total vessel
density (19.90 ±1.56 vs 19.75 ±2.54), central perfusion density (17.37 ±4.89 vs 17.20 ±6.50), peripheral
perfusion density (38.55 ±2.50 vs 37.54 ±6.24), and total perfusion measurement (36.19 ±2.51 vs. 35.67
±4.29). Neither was the Foveal Avascular Zone (0.29 ±0.12 vs 0.30 ±0.11). A significant result was
obtained when comparing the nerve fiber layer of the retina between smokers and non-smokers (94.18
±8.83 vs 99.22 ±8.80).
CONCLUSIONS: It was not observed that smoking influences the vascularization of the retina, but there
was a decrease in the thickness of the Retinal Nerve Fiber Layer (RNFL), being important to consider it in
patients with a history of glaucoma.