Dong-Wei Liu1,2,3, Zeeshan Haq1,2, Daphne Yang1,2, Jay M Stewart1,2. 1. Department of Ophthalmology, University of California, San Francisco, San Francisco, California, United States of America. 2. Department of Ophthalmology, Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California, United States of America. 3. Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.
Abstract
PURPOSE: To investigate any associations between cigarette smoking and retinal microvascular changes in diabetic patients without visible retinopathy. DESIGN: Retrospective, cross-sectional study. PARTICIPANTS: 1099 eyes from 1099 diabetic patients with no clinical evidence of diabetic retinopathy (DR) were included in this study. METHODS: Diabetic patients underwent optical coherence tomography angiography (OCTA) scanning at Zuckerberg San Francisco General Hospital and Trauma Center between April 2018 and September 2019. Patient demographic and clinical information was collected. Standard bivariate statistics and multivariate linear regression were performed. MAIN OUTCOME MEASURES: OCTA parameters included metrics related to the foveal avascular zone (FAZ; area, perimeter, circularity), perfusion density (PD; full, center, inner), and vessel length density (VLD; full, center, inner). RESULTS: The study population included 750 non-smokers and 349 smokers. FAZ perimeter was the only OCTA parameter that was significantly different between the two groups on uncontrolled analysis (P = 0.033). Multivariate regression analyses revealed significant associations between lower VLD full (β = -0.31, P = 0.048), lower VLD inner (β = -0.35, P = 0.046) and a history of smoking. No significant associations between cigarette smoking and either FAZ or PD were detected. CONCLUSIONS: Our results suggest that smoking is likely associated with deleterious changes in the retinal microvasculature of patients with a history of diabetes and no visible DR. Based on these findings, diabetic patients with a history of smoking may benefit from higher prioritization in terms of ophthalmic screening.
PURPOSE: To investigate any associations between cigarette smoking and retinal microvascular changes in diabeticpatients without visible retinopathy. DESIGN: Retrospective, cross-sectional study. PARTICIPANTS: 1099 eyes from 1099 diabeticpatients with no clinical evidence of diabetic retinopathy (DR) were included in this study. METHODS:Diabeticpatients underwent optical coherence tomography angiography (OCTA) scanning at Zuckerberg San Francisco General Hospital and Trauma Center between April 2018 and September 2019. Patient demographic and clinical information was collected. Standard bivariate statistics and multivariate linear regression were performed. MAIN OUTCOME MEASURES: OCTA parameters included metrics related to the foveal avascular zone (FAZ; area, perimeter, circularity), perfusion density (PD; full, center, inner), and vessel length density (VLD; full, center, inner). RESULTS: The study population included 750 non-smokers and 349 smokers. FAZ perimeter was the only OCTA parameter that was significantly different between the two groups on uncontrolled analysis (P = 0.033). Multivariate regression analyses revealed significant associations between lower VLD full (β = -0.31, P = 0.048), lower VLD inner (β = -0.35, P = 0.046) and a history of smoking. No significant associations between cigarette smoking and either FAZ or PD were detected. CONCLUSIONS: Our results suggest that smoking is likely associated with deleterious changes in the retinal microvasculature of patients with a history of diabetes and no visible DR. Based on these findings, diabeticpatients with a history of smoking may benefit from higher prioritization in terms of ophthalmic screening.