Smoking linked to proliferative vitreoretinopathy in eyes with open globe injuries

PHILADELPHIA — Cigarette smoking was associated with proliferative vitreoretinopathy and recurrent retinal detachment in eyes with open globe injuries, according to a study presented here.

“We believe that smoking is a significant risk factor for PVR, at least in a traumatic retinal detachment population,” Dean Eliott, MD, said at Macula 2014. “Smoking influences the four major steps in the pathogenesis of PVR.”

Eliott and colleagues reviewed 893 open globe injuries treated between 1999 and 2011. They assessed the risk factors for retinal detachment before treatment and recurrent detachment associated with PVR.

Results showed that 255 eyes (29%) were diagnosed with retinal detachment. Detachment occurred within 3 months in 36% of those eyes and within 1 year in 47%.

At 12 months, retinas detached in 64% of smokers and 38% of nonsmokers, Eliott said.

“It turns out that if you’re a current smoker, the adjusted hazard ratio is 1.96, which basically means that smoking doubles the incidence of detachment in this case series” Eliott said.

The stages of PVR are inflammation, breakdown of the blood-ocular barrier, release of growth factors, cellular proliferation and migration, and extracellular matrix deposition and contraction, he said.

“It turns out that smoking influences all of these steps,” Eliott said.

It is unknown whether quitting smoking immediately reduces the risk of PVR.

“Nevertheless, it’s a good idea to tell your patients to stop smoking anyway,” he said.

Disclosure: Eliott has financial relationships with Acucela, Advanced Cell Technology, Alcon, Allergan, Bausch + Lomb and Genentech.

Reference

Stryjewski TP, et al. Ophthalmology. 2014;doi:10.1016/j.ophtha.2013.06.045.