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The following is a summary of “Social history and glaucoma progression: the effect of body mass index, tobacco and alcohol consumption on the rates of structural change in patients with glaucoma,” published in the April 2024 issue of Ophthalmology by Youssif et al.

Conditions of chronic diseases worsen when introduced to obesity, smoking, and drinking. However, their impact on glaucoma progression is yet to be known. 

Researchers conducted a retrospective study determining the effects of body mass index (BMI), smoking, and alcohol use on the rate of retinal nerve fiber layer (RNFL) changes in patients with glaucoma over time.  

They analyzed 2,839 eyes of 1,584 glaucoma patients from Duke Ophthalmic Registry. Each patient had at least two spectral-domain optical coherency tomography (SD-OCT) over 6+ months. Self-reported alcohol and tobacco use were extracted from electronic health records, and BMI was averaged. Linear mixed models assessed how each factor influenced RNFL changes over time.

The results showed that the average follow-up was 4.7±2.1 years with 5.1±2.2 SD-OCT tests per eye. Tobacco and alcohol history were noted in 43% and 54% of eyes, respectively, and 34% were obese. Higher BMI slowed glaucoma progression (0.014 µm/year per 1 kg/m², P=0.011). Tobacco and alcohol were not significantly associated with RNFL change rates (P=0.473 and P=0.471, respectively). Underweight individuals had a faster structural loss (-0.768 µm/year, P=0.002).

Investigators concluded that tobacco and alcohol habits didn’t affect RNFL change in patients with glaucoma. However, a higher BMI was linked to slower RNFL loss.

Source: bjo.bmj.com/content/early/2024/04/14/bjo-2023-323186