Higher BMI appears to be protective against glaucoma progression

A study assessed the impact of lifestyle choices on glaucoma progression and found that tobacco and alcohol use did not significantly impact changes in retinal nerve fiber layer (RNFL) over time in this patient population. However, being underweight was associated with significantly faster rates of structural loss compared with normal weight (P=.002). Higher body mass index (BMI) was associated with significantly slower rates of RNFL loss (P=.011).

The study included 1,584 patients (n=2,839 eyes) with glaucoma from the Duke Ophthalmic Registry. Patients had at least 2 spectral-domain optical coherency tomography (SD-OCT) tests conducted over a minimum of 6 months of follow-up. A review of electronic health records yielded a self-reported history of alcohol and tobacco use, and mean BMI was calculated. Researchers used univariable and multivariable linear mixed models to determine the effect of each social parameter on RNFL change over time.

The mean follow-up was 4.7 years, with 5.1 SD-OCT tests conducted per eye. Nearly half of patients reported tobacco (43%) or alcohol (54%) use, and about a third of patients (34%) were obese.

Tobacco and alcohol consumption were not associated with significant RNFL change (P=.473 and P=.471, respectively).

Reference

Youssif AA, Onyekaba NA, Naithani R, et al. Social history and glaucoma progression: the effect of body mass index, tobacco and alcohol consumption on the rates of structural change in patients with glaucoma. Br J Ophthalmol. 2024;bjo-2023-323186. doi:10.1136/bjo-2023-323186