Evaluation of the effect of smokeless tobacco (Maras powder) on choroidal and retinal blood flow: an optical coherence tomography angiography study

Abstract

PURPOSE: To investigate the acute and chronic effects of the use of smokeless tobacco (Maras powder) on macular and choroidal blood flow, via optical coherence tomography angiography (OCTA). The study included 30 eyes of 30 patients using smokeless tobacco (ST) as the study group and 30 eyes of 30 healthy individuals as the control group. All subjects underwent a full ophthalmological examination, and baseline OCTA measurements were taken. Flow area in superficial capillary plexus (SCP), in deep capillary plexus (DCP), in choriocapillaris (mm2) and mean vascular density (VD) and foveal avascular zone in SCP and in DCP were assessed. Subfoveal choroidal thickness (SFCT) and central macular thickness were measured as well. The SFCT measurements were determined to be significantly low in the study group (p < 0.001). In the comparison of the study group measurements at 5m, 30m and 1h after using ST compared to the baseline measurements, SCP and DCP flow area, VD, CC flow area and SFCT were determined to have significantly decreased, statistically (p < 0.001). OCTA could be important in showing that choroidal microvascular structures have been affected before occurence of the apparent clinical signs associated with acute and chronic ST use.