The relationship between stromal cell-derived factor-1, internal carotid artery stiffness index, and patients with non-arteritic anterior ischemic optic neuropathy complicated by macular edema_Chinese Journal of Ocular Fundus Diseases

Authors：

Wang Yao ,  Qi Yanxiu , Ji Yan , Wang Wei

Department of Ophthalmology, The Second Affiliated Hospital of Jiamusi University, Jiamusi 154002, China;

Corresponding author：

Qi Yanxiu, Email: Mengqi99@sina.com

Keywords：

Stromal cell-derived factor-1; Internal carotid artery stiffness index; Non-arteritic anterior ischemic optic neuropathy; Macular edema

DOI：

10.3760/cma.j.cn511434-20250507-00206

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the relationship between stromal cell-derived factor-1 (SDF-1), internal carotid artery stiffness index, and non-arteritic anterior ischemic optic neuropathy (NAION) with macular edema (ME). Methods A retrospective study. A total of 202 patients with NAION diagnosed by ophthalmic examination in Department of Ophthalmology , the Second Affiliated Hospital of Jiamusi University from January 2023 to January 2025 were included in the study. Based on the presence or absence of ME, the patients were divided into the NAION+ME group and the NAION group, with 94 and 108 cases respectively. A prediction model was constructed based on the influencing factors. To comprehensively evaluate the predictive value of SDF-1 and carotid artery stiffness index for NAION with ME, a multidimensional analytical approach was employed. The diagnostic performance of individual and combined markers was assessed by constructing receiver operating characteristic (ROC) curves and calculating the area under the curve (AUC).Multivariate logistic regression analysis was performed to determine their independent predictive value. Stratified subgroup analyses were conducted to explore predictive differences across various populations. Cox proportional hazards regression models were established to evaluate long-term predictive value. Restricted cubic spline (RCS) analysis was applied to reveal potential nonlinear dose-response relationships. Mediation effect models were constructed to analyze the mediating role of carotid artery stiffness index in the association between SDF-1 and NAION with ME. Results In the NAION+ME group, systolic blood pressure (t=6.066), body mass index (t=2.804), disease duration (t=2.552), intraocular pressure (t=2.574), high-density lipoprotein (t=2.729), fasting blood glucose (t=2.022), glycosylated hemoglobin (t=7.235), SDF-1 (t=14.319), and internal carotid artery stiffness index (t=2.633) were higher than those in the NAION group, while diastolic blood pressure was lower (P＜0.05). ROC curve analysis showed that the AUC of SDF-1 combined with internal carotid artery stiffness index in predicting the risk of adverse prognosis was 0.894 [95% confidence interval (CI) 0.803-0.945], with a sensitivity of 87.98% and a specificity of 95.69%. Logistic regression analysis demonstrated significant independent correlations between SDF-1 levels (OR=1.682, 95%CI 1.156-1.986), internal carotid artery stiffness index (OR=1.826, 95%CI 1.369-2.648), and the risk of ME in NAION patients (P＜0.05). Subgroup analysis revealed that elevated SDF-1 and internal carotid artery stiffness index were associated with a higher risk of NAION with ME (P_{for trend}＜0.05). RCS analysis demonstrated a nonlinear dose-response relationship between the continuous changes in SDF-1 and internal carotid artery stiffness index and the risk of NAION with ME (P＜0.05). Mediation effect model analysis showed that internal carotid artery stiffness index played a mediating role between SDF-1 and the risk of NAION with ME. Conclusions SDF-1 and internal carotid artery stiffness index are independent risk factors for ME in NAION patients. The combined detection of these two indicators holds significant value in predicting disease progression.

1.	Salvetat ML, Pellegrini F, Spadea L, et al. Non-arteritic anterior ischemic optic neuropathy (NA-AION): a comprehensive overview[J]. Vision (Basel), 2023, 7(4): 72. DOI: 10.3390/vision7040072.
2.	Chapelle AC, Rakic JM, Plant GT. Nonarteritic anterior ischemic optic neuropathy: cystic change in the inner nuclear layer caused by edema and retrograde maculopathy[J/OL]. Ophthalmol Sci, 2023, 3(1): 100230[2023-10-04]. https://pubmed.ncbi.nlm.nih.gov/36439696/. DOI: 10.1016/j.xops.2022.100230.
3.	Wu Y, Zhang Z, Sun X, et al. Stromal cell-derived factor-1 downregulation contributes to neuroprotection mediated by CXC chemokine receptor 4 interactions after intracerebral hemorrhage in rats[J/OL]. CNS Neurosci Ther, 2024, 30(2): e14400[2023-08-24]. https://pubmed.ncbi.nlm.nih.gov/37614198/. DOI: 10.1111/cns.14400.
4.	Petrova M, Gavino A, Li Y, et al. Comparison of parameters for assessment of carotid stiffness and their association with carotid atherosclerosis in rural australian adults: a pilot study[J]. J Clin Med, 2023, 12(8): 2935-2935. DOI: 10.3390/jcm12082935.
5.	袁晓彤, 颉瑞萍, 王永涛, 等. 非动脉炎性前部缺血性视神经病变的中西医治疗进展[J]. 中国中医眼科杂志, 2022, 32(1): 70-72,76. DOI: 10.13444/j.cnki.zgzyykzz.2022.01.017.Yuan XT, Xie RP, Wang YT, et al. Progress of traditional Chinese medicine and Western Medicine in treating non-ar-teritis anterior ischemic optic neuropathy[J]. Chinese Journal of Chinese Ophthalmology, 2022, 32(1): 70-72,76. DOI: 10.13444/j.cnki.zgzyykzz.2022.01.017.
6.	Takada Y, Fujita M, Takada YK. Virtual screening of protein data bank via docking simulation identified the role of integrins in growth factor signaling, the allosteric activation of integrins, and p-selectin as a new integrin ligand[J]. Cells, 2023, 12(18): 2265-2265. DOI: 10.3390/cells12182265.
7.	陈祉帆, 马桂贤, 李昌茂, 等. 颈内动脉狭窄及合并缺血性脑卒中患者视网膜微血管神经改变特征[J]. 眼科新进展, 2023, 43(6): 454-458. DOI: 10.13389/j.cnki.rao.2023.0091.Chen ZF, Ma GX, Li CM, et al. Characteristics of retinal microvascular nerve changes in patients with internal carotid artery stenosis and combined ischemic stroke[J]. Rec Adv Ophthalmol, 2023, 43(6): 454-458. DOI: 10.13389/j.cnki.rao.2023.0091.
8.	中华医学会眼科学分会神经眼科学组. 我国非动脉炎性前部缺血性视神经病变诊断和治疗专家共识(2015年)[J]. 中华眼科杂志, 2015, 51(5): 323-326. DOI: 10.3760/cma.j.issn.0412-4081.2015.05.002.Neuro-ophthalmology Group, Ophthalmology Branch of Chinese Medical Association. Expert consensus on diagnosis and treatment of non-arteritic anterior ischemic optic neuropathy in China (2015)[J]. Chin J Ophthalmol, 2015, 51(5): 323-326. DOI: 10.3760/cma.j.issn.0412-4081.2015.05.002.
9.	……)[M]//葛坚, 王宁利. 眼科学. 3版. 北京: 人民卫生出版社, 2015: 133-136.Ge J, Wang NL. Ophthalmology. 3rd ed. Beijing: People's Medical Publishing House, 2015: 133-136.
10.	Abri Aghdam K, Aghajani A, Ghamari K, et al. Nonarteritic anterior ischemic optic neuropathy associated with ipsilateral hypoplastic internal carotid artery[J]. Retin Cases Brief Rep, 2023, 17(6): 656-659. DOI: 10.1097/ICB.0000000000001285.
11.	Kasimov M, Popovic MM, Micieli JA. Paracentral acute middle maculopathy associated with anterior ischemic optic neuropathy and cilioretinal artery occlusion in giant cell arteritis[J/OL]. J Neuroophthalmol, 2022, 42(1): e437-e439[2022-03-01]. https://pubmed.ncbi.nlm.nih.gov/34238887/. DOI: 10.1097/WNO.0000000000001306.
12.	Wu Y, Yazdani SK, Bolander J, et al. Syndecan-4 and stromal cell-derived factor-1 alpha functionalized endovascular scaffold facilitates adhesion, spreading and differentiation of endothelial colony forming cells and functions under flow and shear stress conditions[J]. J Biomed Mater Res B Appl Biomater, 2023, 111(3): 538-550. DOI: 10.1002/jbm.b.35170.
13.	Song B, Chen D, Liu Z, et al. Stromal cell-derived factor-1 exerts opposing roles through CXCR4 and CXCR7 in angiotensin II-induced adventitial remodeling[J]. Biochem Biophys Res Commun, 2022, 594(2): 38-45. DOI: 10.1016/j.bbrc.2022.01.030.
14.	Sanches BDA, Tamarindo GH, da Silva ADT, et al. Stromal cell-derived factor 1 (SDF-1) increases the number of telocytes in ex vivo and in vitro assays[J]. Histochem Cell Biol, 2023, 160(5): 419-433. DOI: 10.1007/s00418-023-02223-3.
15.	Mullis DM, Padilla-Lopez A, Wang H, et al. Stromal cell-derived factor-1 alpha improves cardiac function in a novel diet-induced coronary atherosclerosis model, the SR-B1DeltaCT/LDLR KO mouse[J/OL]. Atherosclerosis, 2024, 395(1): 117518[2024-03-22]. https://pubmed.ncbi.nlm.nih.gov/38627162/. DOI: 10.1016/j.atherosclerosis.2024.117518.
16.	吴琳艳, 范茂利, 王凯, 等. 玻璃体切割术联合雷珠单抗对增殖性糖尿病性视网膜病变患者视网膜功能恢复的影响[J]. 医学综述, 2023, 29(22): 5165-5168.Wu LY, Fan ML, Wang K, et al. The influence of vitrectomy combined with ranibizumab on the recovery of retinal function in patients with proliferative diabetic retinopathy[J]. Medical Recapitulate, 2023, 29(22): 5165-5168.
17.	Fico BG, Miller KB, Rivera-Rivera LA, et al. The impact of aging on the association between aortic stiffness and cerebral pulsatility index[J/OL]. Front Cardiovasc Med, 2022, 9: 821151[2022-02-09]. https://pubmed.ncbi.nlm.nih.gov/35224051/. DOI: 10.3389/fcvm.2022.821151.
18.	Lylyk I, Bleise C, Lylyk PN, et al. Ophthalmic artery angioplasty for age-related macular degeneration[J]. J Neurointerv Surg, 2022, 14(10): 968-972. DOI: 10.1136/neurintsurg-2021-018222.
19.	Liu J, Wan J, Kwapong WR, et al. Retinal microvasculature and cerebral hemodynamics in patients with internal carotid artery stenosis[J]. BMC Neurol, 2022, 22(1): 386-386. DOI: 10.1186/s12883-022-02908-7.
20.	Jannati S, Shahri MN, Jafarzadeh N, et al. Non-newtonian pulsatile blood flow through the stenosed arteries: comparison between the viscoelastic and elastic arterial wall in response to the alterations[J]. Biomed Phys Eng Express, 2023, 9(6): 10. DOI: 10.1088/2057-1976/ad0240.
21.	Agbaje AO, Barker AR, Tuomainen TP. Cardiorespiratory fitness, fat mass, and cardiometabolic health with endothelial function, arterial elasticity, and stiffness[J]. Med Sci Sports Exerc, 2022, 54(1): 141-152. DOI: 10.1249/MSS.0000000000002757.
22.	黄熙畅, 赵琳, 张建兴, 等. 针灸对颈动脉粥样硬化早期患者血管弹性的影响[J]. 针刺研究, 2024, 49(6): 611-617. DOI: 10.13702/j.1000-0607.20230354.Huang XC, Zhao L, Zhang JX, et al. The influence of acupuncture on vascular elasticity in patients with early-stage carotid atherosclerosis[J]. Acupuncture Research, 2024, 49(6): 611-617. DOI: 10.13702/j.1000-0607.20230354.
23.	Wang X, Shen Y, Shang M, et al. Endothelial mechanobiology in atherosclerosis[J]. Cardiovasc Res, 2023, 119(8): 1656-1675. DOI: 10.1093/cvr/cvad076.
24.	Xie X, Wang K, Shen X, et al. Potential mechanisms of aortic medial degeneration promoted by co-exposure to microplastics and lead[J/OL]. J Hazard Mater, 2024, 475(3): 134854[2024-08-15]. https://pubmed.ncbi.nlm.nih.gov/38889468/. DOI: 10.1016/j.jhazmat.2024.134854.
25.	Woxholt S, Ueland T, Aukrust P, et al. Effect of tocilizumab on endothelial and platelet-derived CXC-chemokines and their association with inflammation and myocardial injury in STEMI patients undergoing primary PCI[J/OL]. Int J Cardiol, 2025, 418(2): 132613[2025-01-01]. https://pubmed.ncbi.nlm.nih.gov/39374793/. DOI: 10.1016/j.ijcard.2024.132613.
26.	刘婉丽, 谭永辉, 郑翼徳. 基于基质细胞衍生因子-1α/CXCR4通路研究氯吡格雷对大鼠颈动脉狭窄的改善作用[J]. 岭南心血管病杂志, 2022, 28(4): 361-366. DOI: 10.3969/j.issn.1007-9688.2022.04.15.Liu WL, Tan YH, Zheng YD. Improvement effect of clopidogrel on carotid artery stenosis in rats based on stromal cell-derived factor-1α/CXCR4 pathway[J]. South China Journal of Cardiovascular Diseases, 2022, 28(4): 361-366. DOI: 10.3969/j.issn.1007-9688.2022.04.15.

1. Salvetat ML, Pellegrini F, Spadea L, et al. Non-arteritic anterior ischemic optic neuropathy (NA-AION): a comprehensive overview[J]. Vision (Basel), 2023, 7(4): 72. DOI: 10.3390/vision7040072.
2. Chapelle AC, Rakic JM, Plant GT. Nonarteritic anterior ischemic optic neuropathy: cystic change in the inner nuclear layer caused by edema and retrograde maculopathy[J/OL]. Ophthalmol Sci, 2023, 3(1): 100230[2023-10-04]. https://pubmed.ncbi.nlm.nih.gov/36439696/. DOI: 10.1016/j.xops.2022.100230.
3. Wu Y, Zhang Z, Sun X, et al. Stromal cell-derived factor-1 downregulation contributes to neuroprotection mediated by CXC chemokine receptor 4 interactions after intracerebral hemorrhage in rats[J/OL]. CNS Neurosci Ther, 2024, 30(2): e14400[2023-08-24]. https://pubmed.ncbi.nlm.nih.gov/37614198/. DOI: 10.1111/cns.14400.
4. Petrova M, Gavino A, Li Y, et al. Comparison of parameters for assessment of carotid stiffness and their association with carotid atherosclerosis in rural australian adults: a pilot study[J]. J Clin Med, 2023, 12(8): 2935-2935. DOI: 10.3390/jcm12082935.
5. 袁晓彤, 颉瑞萍, 王永涛, 等. 非动脉炎性前部缺血性视神经病变的中西医治疗进展[J]. 中国中医眼科杂志, 2022, 32(1): 70-72,76. DOI: 10.13444/j.cnki.zgzyykzz.2022.01.017.Yuan XT, Xie RP, Wang YT, et al. Progress of traditional Chinese medicine and Western Medicine in treating non-ar-teritis anterior ischemic optic neuropathy[J]. Chinese Journal of Chinese Ophthalmology, 2022, 32(1): 70-72,76. DOI: 10.13444/j.cnki.zgzyykzz.2022.01.017.
6. Takada Y, Fujita M, Takada YK. Virtual screening of protein data bank via docking simulation identified the role of integrins in growth factor signaling, the allosteric activation of integrins, and p-selectin as a new integrin ligand[J]. Cells, 2023, 12(18): 2265-2265. DOI: 10.3390/cells12182265.
7. 陈祉帆, 马桂贤, 李昌茂, 等. 颈内动脉狭窄及合并缺血性脑卒中患者视网膜微血管神经改变特征[J]. 眼科新进展, 2023, 43(6): 454-458. DOI: 10.13389/j.cnki.rao.2023.0091.Chen ZF, Ma GX, Li CM, et al. Characteristics of retinal microvascular nerve changes in patients with internal carotid artery stenosis and combined ischemic stroke[J]. Rec Adv Ophthalmol, 2023, 43(6): 454-458. DOI: 10.13389/j.cnki.rao.2023.0091.
8. 中华医学会眼科学分会神经眼科学组. 我国非动脉炎性前部缺血性视神经病变诊断和治疗专家共识(2015年)[J]. 中华眼科杂志, 2015, 51(5): 323-326. DOI: 10.3760/cma.j.issn.0412-4081.2015.05.002.Neuro-ophthalmology Group, Ophthalmology Branch of Chinese Medical Association. Expert consensus on diagnosis and treatment of non-arteritic anterior ischemic optic neuropathy in China (2015)[J]. Chin J Ophthalmol, 2015, 51(5): 323-326. DOI: 10.3760/cma.j.issn.0412-4081.2015.05.002.
9. ……)[M]//葛坚, 王宁利. 眼科学. 3版. 北京: 人民卫生出版社, 2015: 133-136.Ge J, Wang NL. Ophthalmology. 3rd ed. Beijing: People's Medical Publishing House, 2015: 133-136.
10. Abri Aghdam K, Aghajani A, Ghamari K, et al. Nonarteritic anterior ischemic optic neuropathy associated with ipsilateral hypoplastic internal carotid artery[J]. Retin Cases Brief Rep, 2023, 17(6): 656-659. DOI: 10.1097/ICB.0000000000001285.
11. Kasimov M, Popovic MM, Micieli JA. Paracentral acute middle maculopathy associated with anterior ischemic optic neuropathy and cilioretinal artery occlusion in giant cell arteritis[J/OL]. J Neuroophthalmol, 2022, 42(1): e437-e439[2022-03-01]. https://pubmed.ncbi.nlm.nih.gov/34238887/. DOI: 10.1097/WNO.0000000000001306.
12. Wu Y, Yazdani SK, Bolander J, et al. Syndecan-4 and stromal cell-derived factor-1 alpha functionalized endovascular scaffold facilitates adhesion, spreading and differentiation of endothelial colony forming cells and functions under flow and shear stress conditions[J]. J Biomed Mater Res B Appl Biomater, 2023, 111(3): 538-550. DOI: 10.1002/jbm.b.35170.
13. Song B, Chen D, Liu Z, et al. Stromal cell-derived factor-1 exerts opposing roles through CXCR4 and CXCR7 in angiotensin II-induced adventitial remodeling[J]. Biochem Biophys Res Commun, 2022, 594(2): 38-45. DOI: 10.1016/j.bbrc.2022.01.030.
14. Sanches BDA, Tamarindo GH, da Silva ADT, et al. Stromal cell-derived factor 1 (SDF-1) increases the number of telocytes in ex vivo and in vitro assays[J]. Histochem Cell Biol, 2023, 160(5): 419-433. DOI: 10.1007/s00418-023-02223-3.
15. Mullis DM, Padilla-Lopez A, Wang H, et al. Stromal cell-derived factor-1 alpha improves cardiac function in a novel diet-induced coronary atherosclerosis model, the SR-B1DeltaCT/LDLR KO mouse[J/OL]. Atherosclerosis, 2024, 395(1): 117518[2024-03-22]. https://pubmed.ncbi.nlm.nih.gov/38627162/. DOI: 10.1016/j.atherosclerosis.2024.117518.
16. 吴琳艳, 范茂利, 王凯, 等. 玻璃体切割术联合雷珠单抗对增殖性糖尿病性视网膜病变患者视网膜功能恢复的影响[J]. 医学综述, 2023, 29(22): 5165-5168.Wu LY, Fan ML, Wang K, et al. The influence of vitrectomy combined with ranibizumab on the recovery of retinal function in patients with proliferative diabetic retinopathy[J]. Medical Recapitulate, 2023, 29(22): 5165-5168.
17. Fico BG, Miller KB, Rivera-Rivera LA, et al. The impact of aging on the association between aortic stiffness and cerebral pulsatility index[J/OL]. Front Cardiovasc Med, 2022, 9: 821151[2022-02-09]. https://pubmed.ncbi.nlm.nih.gov/35224051/. DOI: 10.3389/fcvm.2022.821151.
18. Lylyk I, Bleise C, Lylyk PN, et al. Ophthalmic artery angioplasty for age-related macular degeneration[J]. J Neurointerv Surg, 2022, 14(10): 968-972. DOI: 10.1136/neurintsurg-2021-018222.
19. Liu J, Wan J, Kwapong WR, et al. Retinal microvasculature and cerebral hemodynamics in patients with internal carotid artery stenosis[J]. BMC Neurol, 2022, 22(1): 386-386. DOI: 10.1186/s12883-022-02908-7.
20. Jannati S, Shahri MN, Jafarzadeh N, et al. Non-newtonian pulsatile blood flow through the stenosed arteries: comparison between the viscoelastic and elastic arterial wall in response to the alterations[J]. Biomed Phys Eng Express, 2023, 9(6): 10. DOI: 10.1088/2057-1976/ad0240.
21. Agbaje AO, Barker AR, Tuomainen TP. Cardiorespiratory fitness, fat mass, and cardiometabolic health with endothelial function, arterial elasticity, and stiffness[J]. Med Sci Sports Exerc, 2022, 54(1): 141-152. DOI: 10.1249/MSS.0000000000002757.
22. 黄熙畅, 赵琳, 张建兴, 等. 针灸对颈动脉粥样硬化早期患者血管弹性的影响[J]. 针刺研究, 2024, 49(6): 611-617. DOI: 10.13702/j.1000-0607.20230354.Huang XC, Zhao L, Zhang JX, et al. The influence of acupuncture on vascular elasticity in patients with early-stage carotid atherosclerosis[J]. Acupuncture Research, 2024, 49(6): 611-617. DOI: 10.13702/j.1000-0607.20230354.
23. Wang X, Shen Y, Shang M, et al. Endothelial mechanobiology in atherosclerosis[J]. Cardiovasc Res, 2023, 119(8): 1656-1675. DOI: 10.1093/cvr/cvad076.
24. Xie X, Wang K, Shen X, et al. Potential mechanisms of aortic medial degeneration promoted by co-exposure to microplastics and lead[J/OL]. J Hazard Mater, 2024, 475(3): 134854[2024-08-15]. https://pubmed.ncbi.nlm.nih.gov/38889468/. DOI: 10.1016/j.jhazmat.2024.134854.
25. Woxholt S, Ueland T, Aukrust P, et al. Effect of tocilizumab on endothelial and platelet-derived CXC-chemokines and their association with inflammation and myocardial injury in STEMI patients undergoing primary PCI[J/OL]. Int J Cardiol, 2025, 418(2): 132613[2025-01-01]. https://pubmed.ncbi.nlm.nih.gov/39374793/. DOI: 10.1016/j.ijcard.2024.132613.
26. 刘婉丽, 谭永辉, 郑翼徳. 基于基质细胞衍生因子-1α/CXCR4通路研究氯吡格雷对大鼠颈动脉狭窄的改善作用[J]. 岭南心血管病杂志, 2022, 28(4): 361-366. DOI: 10.3969/j.issn.1007-9688.2022.04.15.Liu WL, Tan YH, Zheng YD. Improvement effect of clopidogrel on carotid artery stenosis in rats based on stromal cell-derived factor-1α/CXCR4 pathway[J]. South China Journal of Cardiovascular Diseases, 2022, 28(4): 361-366. DOI: 10.3969/j.issn.1007-9688.2022.04.15.

Chinese Journal of Ocular Fundus Diseases

Latest ArticlesThe relationship between stromal cell-derived factor-1, internal carotid artery stiffness index, and patients with non-arteritic anterior ischemic optic neuropathy complicated by macular edema

Abstract Full text Figures/Tables Video References Cited by

Format

Content