The effect of electronic cigarette smoking on retinal microcirculation: Enlargement of the foveal avascular zone

Kalaycı, Mustafa; Çetinkaya, Ersan; Süren, Elçin; Yiğit, Kenan; Duman, Fulya; Erol, Muhammet Kazım

doi:10.1016/j.pdpdt.2020.102068

Cited by 12 publications

(9 citation statements)

References 29 publications

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“…Our findings that observed abnormal retinal microvasculature may help partially explain the reason why heavy smokers are more likely to develop these ocular conditions (Lois et al 2008;Tam et al 2009;Cai et al 2018;Rozing et al 2020). Nevertheless, several studies indicated that the RCP vessel density of nonsmokers is not different from that of smokers (Ayhan et al 2017 Kalayci et al 2020;Aboud et al 2021), which are contradictory to our results. These inconsistencies could be attributed to different cumulative smoking amounts, small sample size, limited adjustments for potential confounders and potential selection bias.…”

Section: Discussioncontrasting

confidence: 99%

“…In our study, we showed that smoking history is associated with low deep RCP vessel density in the parafovea. This finding is similar to that of previous studies on the diabetic or healthy smokers (Lee et al 2018b;Ting et al 2017;Dogan et al 2020;Kalayci et al 2020;Aboud et al 2021). This may be because of the nicotine and oxidizing agents in tobacco that could cause hypoperfusion, vessel wall damage and capillary dropout of the retinal microvasculature (Perkins et al 1986;Edirisinghe & Rahman 2010).…”

Section: Discussionsupporting

confidence: 92%

“…Several OCTA studies reported abnormal retinal microcirculation in healthy or diabetic smokers (Ting et al 2017;Kalayci et al 2020;Aboud et al 2021). However, previous studies involving RCP vessel density and FAZ area yielded inconsistent results due to heterogeneous study designs, different cumulative smoking amounts and limited adjustments for potential confounders (Ting et al 2017 Aboud et al 2021).…”

Section: Introductionmentioning

confidence: 99%

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Association of cigarette smoking with retinal capillary plexus: an optical coherence tomography angiography study

Zhu

Yang

Xiao

et al. 2022

Acta Ophthalmologica

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Purpose: To investigate the association between cigarette smoking and retinal capillary plexus (RCP) using optical coherence tomography angiography (OCTA) and to examine whether potential vascular risk factors could impact their association. Methods: This is a cross-sectional, community-based study. The Jidong Eye Cohort Study included participants aged ≥18 years in the Jidong community (Tangshan city, northern China) from August 2019 to January 2020. All participants underwent comprehensive ophthalmic examination and completed detailed smoking questionnaires. Retinal vessel density in the superficial and deep RCP was automatically measured using OCTA. Results: Of the 2598 participants included in the study, 2026 (78.0%) never smoked and 572 (22.0%) had a history of smoking (494 [19.0%] current smokers and 78 [3.0%] former smokers). The median (interquartile range) age was 41 (34-52) years for the non-smoking group and 45 (35-54.5) years for the smoking group. Multivariable analysis showed that smoking history is associated with a low deep RCP vessel density in the parafovea (b, À0.53; 95% confidence interval [CI], À0.82 to À0.24) and four quadrants. Increased smoking pack-years were associated with reduced deep RCP vessel density in the parafovea (p for trend <0.001) and four quadrants. The significant interaction between diabetes and smoking only was found for superficial RCP vessel density in the parafovea (p for interaction = 0.014) and four quadrants except for the temporal quadrants. Conclusions: Cigarette smoking is an independent risk factor for reduced deep RCP vessel density. Our findings imply the potential detrimental effect of smoking on the occurrence of ocular diseases.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

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Association of cigarette smoking with retinal capillary plexus: an optical coherence tomography angiography study

Zhu

Yang

Xiao

et al. 2022

Acta Ophthalmologica

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“…Our results of declines in mitochondrial membrane potential induced by the vehicle (PG/VG) alone indicate that the vehicle in EC can in itself impair functions. A previous report where mice were exposed to EC vapors showed damage to retinal microvasculature by the PG vehicle [ 28 ] while another study postulated that the vapors generated from PG produced formaldehyde on heating which led to ischemia and cellular damage in retinal vessels [ 27 ]. Although we did not observe any significant effect of flavors per se on mitochondrial membrane potential, the possibility that these flavors might contribute to oxidative stress by inducing the production of reactive oxygen species (ROS) cannot be ruled out, since it has been reported previously that flavors in EC induced the generation of hydroxyl radicals and ROS [ 51 , 52 ].…”

Section: Discussionmentioning

confidence: 99%

“…Cigarette smoking has been established as a key risk factor in the pathogenesis of AMD [ 24 , 25 , 26 ]; however, there are only two reports which have explored the effects of EC on retinal tissues. In one study, the authors demonstrated that EC use in healthy men led to decreased vascular density with development of hypoxia in retinal tissue [ 27 ]. In another study, whole-body exposure of mice to vapors from unflavored nicotine-free and unflavored nicotine-rich EC showed damage to retinal microvasculature; the presence of nicotine led to further enhanced secretion of inflammatory mediators and angiogenic factors exacerbating the damage [ 28 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of E-Cigarette Refill Liquid Flavorings with and without Nicotine on Human Retinal Pigment Epithelial Cells: A Preliminary Study

Goenka

Simon

2021

IJERPH

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Smoking is an etiologic factor for age-related macular degeneration (AMD). Although cigarette smoke has been extensively researched for retinal pigment epithelial (RPE) cell degeneration, the potential for adverse effects on the retinal epithelium following exposure to flavored e-cigarette refill liquid has never been explored. In this preliminary study, we have examined the effects of 20 e-liquids (10 different flavored nicotine-free and 10 nicotine-rich e-liquids) used in e-cigarettes on the metabolic activity, membrane integrity, and mitochondrial membrane potential of RPE cells. Our results showed that of the flavors studied over the concentration range: 0.5, 1, and 2% v/v for a duration of 48 h, cinnamon was the most toxic and menthol was the second most toxic, while other flavors showed lesser or no cytotoxicity. The presence of nicotine augmented cytotoxicity for cinnamon, menthol, strawberry, vanilla, and banana while for other flavors there was no synergism. Together, our results demonstrate that exposure of RPE to flavored e-cigarette refill liquids caused significant cytotoxicity and may be a risk factor for the development of retinal pathogenesis, although further in-depth studies are necessary.

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E-cigarette effects on vascular function in animals and humans

Daiber

Kuntic

Oelze

et al. 2023

Pflugers Arch - Eur J Physiol

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Smoking tobacco cigarettes is a significant (cardiovascular) health risk factor. Although the number of tobacco cigarette users declined over the last decades, shisha smoking and e-cigarette vaping partially compensated for this health benefit. E-cigarettes may create highly addicted dual users (vaping and smoking). E-cigarettes seem not to represent a healthier alternative to tobacco smoking, although they may be less harmful. E-cigarette vaping causes oxidative stress, inflammation, endothelial dysfunction, and associated cardiovascular sequelae. This is primarily due to a significant overlap of toxic compounds in the vapor compared to tobacco smoke and, accordingly, a substantial overlap of pathomechanistic features between vaping and smoking. Whereas the main toxins in vapor are reactive aldehydes such as formaldehyde and acrolein, the toxic mixture in smoke is more complex, comprising particulate matter, reactive gases, transition metals, volatile organic compounds, and N-nitrosamines. However, it seems that both lifestyle drugs impair endothelial function to a quite similar extent, which may be due to the role of oxidative stress as the central pathomechanism to mediate endothelial dysfunction and vascular damage. Finally, the main selling argument for e-cigarette use that they help to quit smoking and get rid of nicotine addiction may be false because it seems that e-cigarettes instead trigger the opposite—younger entrance age and more frequent use. With our review, we summarize the adverse health impact of tobacco cigarettes and e-cigarettes, emphasizing the detrimental effects on endothelial function and cardiovascular health.

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The effect of electronic cigarette smoking on retinal microcirculation: Enlargement of the foveal avascular zone

Cited by 12 publications

References 29 publications

Association of cigarette smoking with retinal capillary plexus: an optical coherence tomography angiography study

Association of cigarette smoking with retinal capillary plexus: an optical coherence tomography angiography study

Effects of E-Cigarette Refill Liquid Flavorings with and without Nicotine on Human Retinal Pigment Epithelial Cells: A Preliminary Study

E-cigarette effects on vascular function in animals and humans

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