Effect of smoking on the macula and optic nerve integrity using optical coherence tomography angiography

To investigate the effect of chronic smoking on the macula and optic nerve integrity using optical coherence tomography angiography (OCTA).

This prospective, comparative study involved the right eyes of 160 healthy subjects (80 smokers group, and 80 control group). OCTA scanning was performed for all subjects. All macular subfields thickness, peripapillary retinal nerve fiber layer (RNFL) thickness, macular ganglion cell complex (GCC) thickness, superficial and deep macular vessel density, foveal avascular zone (FAZ) area, and the macular outer retina flow area, were measured and analyzed.

The thickness of some macular subfields, inferior GCC, and RNFL was statistically significantly lower in the smokers' group (p < 0.05). The FAZ area was 0.409 ± 0.048 mm² in the smokers' group and 0.327 ± 0.055 mm² in the control group (p < 0.001). The superficial foveal VD was 31.35 ± 5.79% in the smokers' group and 33.63 ± 4.78% in the control group (p = 0.06). The deep foveal VD was 39.38 ± 4.56% in the smokers' group and 34.15 ± 6.57% in the control group (p ≤ 0.001). The superficial and deep parafoveal VD was 52.09 ± 4.56% and 59.99 ± 2.25% respectively in the smokers' group, and 54.75 ± 2.30% and 55.58 ± 4.69% respectively in the control group (p < 0.05). The macular outer retina flow area was 1.29 ± 0.12 mm² in the smokers' group and 1.16 ± 0.11 mm² in the control group (p < 0.001).

Chronic smoking affected the integrity of the macula and optic nerve. It decreased the macular VD, enlarged the FAZ, and increased outer retinal flow area.