It’s well known that harmful chemicals contained in cigarettes can cause various cancers as well as cardiovascular or pulmonary diseases, but there’s also a strong association between smoking and eye diseases.

A recent cross-sectional study conducted in Turkey investigated the effects of chronic cigarette use on retinal vascular parameters by using OCT angiography to document changes in otherwise healthy individuals. Twenty-four smokers (18 men, six women, mean age 28.1) and 26 non-smokers (19 men, seven women, mean age 27.4) were included. Mean smoking duration was 3.7 years and mean daily consumption of cigarettes was 1.0±0.5 packs. Those with a history of ocular surgery/trauma, active or previous ocular pathology, systemic disease, high refractive error or atypical axial length were excluded.

Results showed the vascular densities of the deep capillary plexus in parafoveal and perifoveal regions were statistically significantly lower in the smokers group compared with controls. However, despite vascular density being lower in a 300µm-wide region surrounding the foveal avascular zone in the smokers group, this difference was not deemed significant (p=0.242).

The authors believe this is the first study to show that smoking causes deep capillary plexus alternations. “This result suggests that smoking may cause a local ischemic microenvironment, bearing in mind the effects of smoking on the choroidal, choriocapillaris and deep capillary plexus circulation.” They go on to speculate that this “may be a risk factor for the development of type-1, type-2 and type-3 choroidal neovascularization in smoking patients.”

These results may reflect the impact early smoking can have on the microvascular system generally and that of the eye in particular.

Dogan M, Akdogan M, Gulyesil FF, et al. Cigarette smoking reduces deep retinal vascular integrity. Clin Exp Optom. 2020;103:838-42.