Background/aims Although obesity, tobacco and alcohol consumption were linked to the progression of numerous chronic diseases, an association of these social history aspects with glaucoma progression is not yet determined. This study aims to investigate the effect of body mass index (BMI) and history of tobacco and alcohol use on the rates of retinal nerve fibre layer (RNFL) change over time in glaucoma patients. Methods 2839 eyes of 1584 patients with glaucoma from the Duke Ophthalmic Registry were included. Patients had at least two spectral-domain optical coherency tomography (SD-OCT) tests over a minimum 6-month follow-up. Self-reported history of alcohol and tobacco consumption was extracted from electronic health records and mean BMI was calculated. Univariable and multivariable linear mixed models were used to determine the effect of each parameter on RNFL change over time. Results Mean follow-up time was 4.7±2.1 years, with 5.1±2.2 SD-OCT tests per eye. 43% and 54% of eyes had tobacco or alcohol consumption history, respectively, and 34% were classified as obese. Higher BMI had a protective effect on glaucoma progression (0.014 µm/year slower per each 1 kg/m2 higher; p=0.011). Tobacco and alcohol consumption were not significantly associated with RNFL change rates (p=0.473 and p=0.471, respectively). Underweight subjects presented significantly faster rates of structural loss (−0.768 µm/year; p=0.002) compared with normal weight. Conclusions In a large clinical population with glaucoma, habits of tobacco and alcohol consumption showed no significant effect on the rates of RNFL change. Higher BMI was significantly associated with slower rates of RNFL loss. Data are available on reasonable request.

中文翻译：

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社会史和青光眼进展：体重指数、吸烟和饮酒对青光眼患者结构变化率的影响

背景/目标 尽管肥胖、吸烟和饮酒与许多慢性疾病的进展有关，但这些社会史方面与青光眼进展的关联尚未确定。本研究旨在探讨青光眼患者体重指数 (BMI) 和烟酒使用史对视网膜神经纤维层 (RNFL) 随时间变化率的影响。方法 纳入杜克眼科登记处 158​​4 名青光眼患者的 2839 只眼睛。在至少 6 个月的随访期间，患者至少接受了两次谱域光学相干断层扫描 (SD-OCT) 测试。从电子健康记录中提取自我报告的饮酒和吸烟史，并计算平均体重指数。使用单变量和多变量线性混合模型来确定每个参数对 RNFL 随时间变化的影响。结果 平均随访时间为 4.7±2.1 年，每只眼进行 5.1±2.2 次 SD-OCT 测试。 43%和54%的眼睛分别有吸烟或饮酒史，34%被归类为肥胖。 BMI 较高对青光眼进展具有保护作用（每升高 1 kg/m2，每年减慢 0.014 µm；p=0.011）。吸烟和饮酒与 RNFL 变化率没有显着相关（分别为 p=0.473 和 p=0.471）。与正常体重相比，体重不足的受试者表现出明显更快的结构损失率（−0.768 µm/年；p=0.002）。结论 在大量青光眼临床人群中，烟酒消费习惯对 RNFL 变化率没有显着影响。较高的 BMI 与较慢的 RNFL 损失率显着相关。可根据合理要求提供数据。