Quantitative fundus autofluorescence in smokers compared to non-smokers

Area of Science:

• Ophthalmology
• Retinal Imaging
• Public Health

Background:

• Increased fundus autofluorescence (qAF) is linked to retinal pigment epithelium (RPE) lipofuscin, a marker associated with age-related macular degeneration (AMD).
• Smoking is a major modifiable risk factor for AMD, potentially through oxidative stress and RPE toxicity.
• The direct relationship between smoking and qAF remains unclear, necessitating further investigation into AMD pathogenesis.

Purpose of the Study:

• To compare quantitative fundus autofluorescence (qAF) in healthy non-smokers and smokers.
• To investigate the association between smoking status and qAF in the retina.
• To explore potential insights into AMD pathogenic mechanisms.

Main Methods:

• A cross-sectional study involving 105 participants (54 smokers) at the 2016 Minnesota State Fair.
• Participants underwent self-reported history, eye examination, and qAF imaging using a Spectralis confocal scanning laser ophthalmoscope (cSLO).
• Stepwise multiple mixed effects regression analysis was employed to assess the relationship between qAF and smoking status, adjusting for age and gender.

Main Results:

• Older age and female gender were independently associated with higher qAF values.
• A positive smoking history showed a trend towards higher qAF, but this was not statistically significant (P=0.056).
• The number of pack-years smoked among smokers was not significantly associated with increased qAF.

Conclusions:

• While older age predicts intensified autofluorescence, smoking history appears to have a less significant impact on qAF than hypothesized.
• Quantitative fundus autofluorescence may not be the most suitable clinical tool for evaluating the direct impact of smoking on the retina.
• Further research is needed to fully elucidate the complex relationship between smoking, retinal changes, and AMD development.