Smoking and short-term response to intravitreal anti-Vascular Endothelial Growth Factor injections in neovascular age-related macular degeneration

Purpose. - To evaluate the role of smoking status on the response to three monthly intravitreal anti -Vascular Endothelial Growth Factor (anti-VEGF) injections in treatment -naive neovascular AMD (nAMD) patients. Methods. - We conducted a single -center, retrospective, case -control cohort study in Belgium. Results. - Intravitreal treatment (IVT) was performed in 147 eyes of 131 patients, including 92 females (70%). Mean age at the time of the first IVT was 79 +/- 9 years. Seventeen patients (13%) were actively smoking at the time of the anti-VEGF IVT. On average, active smokers were 11 years younger than non-smokers when starting IVT treatment. They also showed more frequent subretinal fluid than non-smokers (94% vs. 65%). Mann -Whitney analyses comparing change in central macular thickness and change in logarithm of the minimum angle of resolution visual acuity between active smokers and non-smokers showed no significant difference in treatment response between both groups. Likewise, no significant difference was found when comparing treatment response between patients with less than 10 pack-years (PY) (including never-smokers) and patients with over 10 PY. In a binary logistic regression model, male patients responded worse to anti-VEGF IVT than their female counterparts, with an odds ratio (OR) of 0.27 for good response. This was the only statistically significant predictor of treatment response. Conclusion. - Our study failed to demonstrate an effect of smoking on the short-term treatment response to anti-VEGF in nAMD. (c) 2023 Published by Elsevier Masson SAS.