Active Smoking Linked to Progression of Sickle Cell Retinopathy

FRIDAY, Oct. 9, 2026 (HealthDay News) — Active smoking is associated with progression of sickle cell retinopathy (SCR), according to a study published in the November issue of the American Journal of Ophthalmology.

Anshuman Agrawal, from Wilmer Eye Institute in Baltimore, and colleagues conducted a retrospective cohort study involving patients with SCR (317 patients with 620 eyes) seen at least once between July 1, 2013, and June 30, 2023. Progression was assessed from baseline nonproliferative sickle retinopathy (NPSR) to proliferative sickle retinopathy (PSR) and from baseline PSR to more advanced PSR.

The researchers found that progression occurred in 10.7 and 17.0 percent of baseline NPSR eyes and at-risk baseline PSR eyes, respectively (median follow-up, 7.8 and 11.1 years, respectively). There was a significant association for active smoking at PSR diagnosis with progression to more advanced PSR (hazard ratio, 2.78). No association was seen for age at diagnosis, sex, genotype, hydroxyurea use, blood transfusions, chronic red cell exchanges, bone marrow transplantation, and lifetime smoking history with progression of SCR. No correlation was seen for qualitative assessment of macular optical coherence tomography findings with baseline peripheral vascular stage or SCR progression.

“Smoking has been implicated in many different eye diseases, such as age-related macular degeneration, and we believe this is the first study showing a clear link between active smoking and sickle cell retinopathy progression,” Agrawal said in a statement. “With this knowledge, clinicians and patients now have a direct and actionable means of preserving the patient’s eye health.”

Several authors disclosed ties to the biopharmaceutical and ophthalmology industries.

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