Smoking and Wet AMD Treatment

It has long been known that cigarette smoking reduces levels of plasma antioxidant, which protects retinal cells. It is also suspected as a contributor to cataract formation, restriction of night vision, and amblyopia (“lazy eye”). As reported in the September 2020 issue of the journal, Retina, a research team has confirmed the effect of smoking on the one-year visual outcomes in eyes treated with anti-VEGFs for wet (neovascular) age-related macular degeneration (nAMD). 

After analyzing 837 patients with nAMD from 2006 to 2016, researchers found that current smokers have an up to sevenfold greater risk of developing nAMD than nonsmokers, and they tended to have a more aggressive disease state. Additionally, nonsmokers who underwent anti-VEGF treatment were found to have more than twice the gain in visual acuity after a year.

This finding adds to the literature on the ill effects of smoking on people with either dry or wet AMD. The reason for the association between current smoking and poorer visual outcomes with anti-VEGFs is still not totally understood, but research has found that a genetic component (specifically the LOC387715 gene) is likely involved.


“Smoking Status and Treatment Outcomes of Vascular…” . Vittorio AF, Nguyen V, Barthelmes D, et al. Retina 2020;40:1696-1703. 

“No Smoking” by Linda Kaspari (published online at Living Well With Low Vision, 2006)