The sooner a smoker quits, the better their chances of protecting their optic nerve from deterioration. To examine if and how giving up smoking slows the worsening of glaucomatous damage to the eyes’ peripheral (or “vicinity”) visual field (VF). Patients with primary open angle glaucoma with at least 5 VFs and 3 years of follow-up were considered. After controlling for potential confounders, the researchers used linear mixed models to examine whether or not smoking was associated with increased rates of mean deviation loss in VF at the 24-2 levels. They employed Cox proportional hazard regression to see if there was a correlation between the severity of a smoker’s habit and the rate at which VF advanced after they quit. The study included 511 eyes from 354 individuals with a mean follow-up of 12.4 years. The average age at baseline was 62.3 (95% CI: 61.2, 63.4) years. Around 421 patients (42.1%) were active smokers. More intense smokers experienced a greater rate of VF loss (−0.06, 95% CI (−0.10, −0.01) dB/year per 10 pack-years, P=0.01). The risks of VF advancement were considerably higher in former heavy smokers (≥20 pack-years) compared with never-smokers (odds ratio=2.49 (1.01, 6.08); P=0.046). Heavy smokers who had quit for more than 25 years had the same risk of VF development as never smokers (P=0.43). By Kaplan-Meier analysis, heavy smokers who quit for less than 25 years had a significantly higher risk of VF advancement than heavy smokers who quit for more than or equal to 25 years (P=<0.001). Heavy smokers who quit for at least 25 years have a similar risk of VF development as nonsmokers. Glaucoma patients who have quit smoking for an extended period of time may experience slower progression of VF.
