Effect of smoking on retrobulbar blood flow in thyroid eye disease

• Published in: Eye (London) Vol. 30; no. 12; pp. 1573 - 1578
• Main Authors: Sadeghi-Tari, A, Jamshidian-Tehrani, M, Nabavi, A, Sharif-Kashani, S, Elhami, E, Hassanpour, N, Ameli Zamani, K
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.12.2016; Nature Publishing Group
• Subjects: 692/308; 692/699/3161; Adult; Analysis of Variance; Blood Flow Velocity - physiology; Clinical Study; Eye - blood supply; Female; Graves Ophthalmopathy - physiopathology; Humans; Laboratory Medicine; Male; Medicine; Medicine & Public Health; Middle Aged; Ophthalmic Artery - physiology; Ophthalmology; Orbit - blood supply; Pharmaceutical Sciences/Technology; Prospective Studies; Regional Blood Flow - physiology; Retinal Artery - physiology; Retinal Vein - physiology; Smoking - adverse effects; Surgery; Surgical Oncology; Ultrasonography, Doppler, Color; Young Adult
• ISSN: 0950-222X; 1476-5454
• DOI: 10.1038/eye.2016.184

Purpose To evaluate the effect of smoking on retrobulbar blood flow parameters by color Doppler imaging in patients with thyroid eye disease. Patients and methods In this observational case series, blood flow parameters in the ophthalmic artery, superior ophthalmic vein, central retinal artery, and vein were determined by color Doppler imaging in patients with thyroid eye disease. Patients were grouped as smokers and non-smokers. Never smokers and those who had stopped smoking for at least 1 year before onset of ophthalmopathy were considered as non-smokers. A thorough ophthalmic examination including Hertel exophthalmometry was performed. Orbital CT scan was also carried out in all patients. Results Fifty-one orbits from 30 patients between 21 and 62 years old (mean±SD: 40.8±12.0) were enrolled in this study. Smokers had greater proptosis and more active and sever disease. ( P <0.05) Muscle involvement based on CT scan did not vary in smokers and non-smokers. Maximum velocity (3.78±1.74 vs 5.27±2.14, P <0.001; t -test) and minimum velocity (1.74±0.78 vs 3.26±1.36, P =0.014; t -test) in superior ophthalmic vein were significantly lower in smokers than non-smokers. Even after adjusting for age, sex, and clinical activity score and severity, smokers had a lower minimum velocity in superior ophthalmic vein ( P =0.01; ANCOVA analysis). Conclusion Cigarette smoking may correlate with increase in orbital venous congestion in thyroid eye disease.