Effect of Smoking on Macular Perfusion Using Optical Coherence Tomography Angiography

: Background: Chronic smoking's impact on ocular health remains an area of concern, particularly its effect on macular perfusion. This study aimed to evaluate the influence of long-term smoking on macular perfusion using Optical Coherence Tomography Angiography (OCTA). Methods : A prospective, randomized clinical trial was conducted at Benha University Hospital's ophthalmology division from January 2020 to December 2021. Forty participants were divided into smoking (Group 1) and control (Group 2) groups. Exclusion criteria included systemic and ocular diseases, refractive errors, retinal vasculopathies, ocular surgeries, or media opacity. OCTA assessed macular perfusion, while other ophthalmic parameters were measured. Results: The smoking group exhibited a higher smoking index (490.00±325.64) and duration (17.30±7.37 years) compared to controls. Despite comparable visual acuity and intraocular pressure between groups, smokers demonstrated significantly lower superficial and deep layer densities across various macular regions (p < 0.001). The foveal avascular zone (FAZ) area was notably larger in smokers (p < 0.001), indicating compromised perfusion. Conclusions: DCP's is more vulnerable to oxidative damage and poor perfusion brought by cigarette smoking, which led to a considerable drop in VD of DCP compared to SCP. In addition, bigger research examining the long-term effect of smoking on retinal microcirculation in the macula may help clarify the significance of smoking as a risk factor for systemic vascular diseases.