Chronic Alcohol, Tobacco Use Might Cause Retinal Nerve Fiber Layer Thinning

Hands of alcoholic man holding a glass with alcohol drink with smoking cigarette in the ashtray. Alcohol and cigarette addiction. Depression. Loneliness. Sadness.
The study evaluated patients using spectral-domain OCT.

Chronic use of alcohol and tobacco are associated with retinal nerve fiber layer (RNFL) thinning, according to a study in Journal Français d’Ophtalmologie. The researchers recommend evaluating patients with alcohol and tobacco use disorder (ATUD) using optical coherence tomography (OCT) to help identify visual morbidity. 

The study included 29 patients with ATUD and 29 age and gender-matched healthy participants without alcohol dependency, with data from all patients’ right eyes. The ATUD patients consumed 14.84±6.43 standard drink units a day on average, with average duration of alcohol use 18.76±12.22 years. All ATUD patients used tobacco. Both groups had 28 men and 1 woman. 

Each patient had a full ophthalmologic examination including visual acuity, intraocular pressure, anterior segment and fundus examinations, and RNFL measurements taken with spectral-domain OCT. Then, researchers compared the RNFL values of each group.

They found that, in comparison with the control group, ATUD patients had thinner RNFL in all quadrants. The thinning in superotemporal, temporal, and inferotemporal quadrants was statistically significant (P =.012, P =.040, and P =.005, respectively).

“RNFL decrease in optic neuropathy caused by alcohol and tobacco use could predict visual morbidity and mortality, and it could give clinicians help about the severity of the condition in ATUD treatment. Future studies could shed more light on the issue,” according to investigators. “Previous studies have shown a significant correlation between the thinning in RNFL and the increase in the severity and duration of the diseases characterized by neurodegeneration.”

The study’s limitations include its cross-sectional design, its small sample size, and the fact that patients used both alcohol and tobacco (and not just alcohol). “Prospective studies to be performed in the future including high numbers of patients who have only alcohol addiction could provide more detailed data,” according to researchers.


Şahin T, Karadere ME, Yıldız V, Çobanoğlu E. Evaluation of the retinal nerve fiber layer with optic coherence tomography in patients with alcohol use disorder. J Fr Ophtalmol. 2021:44(5):665-669. doi:10.1016/j.jfo.2020.11.009.