A study from the University of Sydney has found that smoking cessation may benefit patients being treated for wet AMD. The researchers documented the prevalence of smoking among patients with wet AMD and reported that current smokers were diagnosed 5.5 years earlier than those who never smoked and 4.4 years earlier than those who used to smoke.  The study also noted central macular thickness was significantly higher in current smokers compared with past smokers at baseline. Being a current smoker at baseline compared with never smoking was associated with an almost two-fold greater likelihood of the presence of subretinal fluid 12 months later.

The study assessed 547 patients with wet AMD, of whom 490 were seen 12 months later. Self-reported history designated their smoking status as never, past or current. Age of AMD onset was defined as the date of wet AMD diagnosis in either eye or date of first anti-VEGF injection. The overall prevalence of never, past and current smokers among those with wet AMD presenting for anti-VEGF treatment was 50%, 40% and 10%, respectively.

The researchers noted that the later age of onset found in past smokers compared with current smokers could suggest the potential for reversibility and highlights the potential benefit of stopping smoking even after developing AMD. Vision impairment or blindness due to macular degeneration at a younger age in those who smoke can have significant economic and social impact, and the researchers firmly believe that interventions that help smoking cessation are more cost-effective compared with the cost of treating AMD. 

Deteram HD, Joachim N, Liew G, et al. Smoking and treatment outcomes of neovascular age-related macular degeneration over 12 months. Br J Ophthalmol. September 26, 2019. [Epub ahead of print].