Clinical profile and risk factors of non-arteritic anterior ischemic optic neuropathy_Chinese Journal of Ocular Fundus Diseases

Authors：

ChenTing , ShanGuangliang , MaJin ,  钟勇

Department of Ophthalmology, Chinese Academy of Medical Sciences & Peking Union Medical College, Peking Union Medical College Hospital, Beijing 100730, China;

Corresponding author：

钟勇, Email: yzhong_eye@163.com

Keywords：

Optic neuropathy, ischemic/etiology; Risk factors

DOI：

10.3760/cma.j.issn.1005-1015.2015.06.003

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Objective To observe the clinical profile and risk factors of non-arteritic anterior ischemic optic neuropathy (NAION). Methods Prospective study was conducted to consecutively recruit 73 patients with NAION from October 2013 through September 2015. A detailed history of previous systemic diseases, smoking and drinking was collected, and a comprehensive ophthalmic evaluation was performed. The prevalence of associated risk factors in NAION patients were compared to the 146 age-and gender-matched normal subjects, and assessed in logistic regression model. Results Of the 73 patients, 65.75% were males, 34.25% were females. The mean age was (55.18±9.89) years. 21.92% were bilateral and 78.08% were unilateral. Arcuate visual field defect (31.58%) was the most prevalent defect detected in unilateral NAION, and there were 8.93% fellow eyes with abnormal optic disc formation in incipient stage. Concentric visual field contraction (40.63%) was the most common in bilateral NAION. Obesity (OR=8.09, 95% CI: 2.94-22.23, P < 0.001) and diabetes (OR=4.72, 95% CI: 1.57-14.25, P=0.006) were significantly associated with NAION. While smoking was marginally associated with NAION (OR=2.76, 95% CI: 1.02-7.53, P=0.047). Conclusions The gender predisposition should be reconsidered in NAION. We should pay attention to the fellow eye in case of the incipient NAION patients. Diabetes and obesity are associated with NAION.

Citation： ChenTing, ShanGuangliang, MaJin. Clinical profile and risk factors of non-arteritic anterior ischemic optic neuropathy. Chinese Journal of Ocular Fundus Diseases, 2015, 31(6): 524-527. doi: 10.3760/cma.j.issn.1005-1015.2015.06.003 Copy

1.	Papchenko T, Grainger BT, Savino PJ, et al. Macular thickness predictive of visual field sensitivity in ischaemic optic neuropathy[J]. Acta Ophthalmol, 2012, 90(6): 463-469.
2.	Carter JE. Anterior ischemic optic neuropathy and stroke with use of PDE-5 inhibitors for erectile dysfunction: cause or coincidence?[J]. J Neurol Sci, 2007, 262(1-2): 89-97.
3.	Levin LA, Louhab A. Apoptosis of retinal ganglion cells in anterior ischemic optic neuropathy[J]. Arch Ophthalmol, 1996, 114(4): 488-491.
4.	陈婷, 马瑾, 钟勇.非动脉炎性前部缺血性视神经病变危险因素的研究进展[J].中华眼科杂志, 2013, 49(11): 1049-1051.
5.	Miller NR, Arnold AC. Current concepts in the diagnosis, pathogenesis and management of nonarteritic anterior ischaemic optic neuropathy[J]. Eye (Lond), 2015, 29(1): 65-79.
6.	Morris PB, Ference BA, Jahangir E, et al. Cardiovascular effects of exposure to cigarette smoke and electronic cigarettes: clinical perspectives from the prevention of cardiovascular disease section leadership council and early career councils of the American College of Cardiology[J]. J Am Coll Cardiol, 2015, 66(12): 1378-1391.
7.	田国红, 贾楠, 陆长峰, 等.非动脉炎性前部缺血性视神经病变的临床特征分析[J].中华眼科杂志, 2009, 45(12): 1064-1067.
8.	Falavarjani KG, Sanjari MS, Modarres M, et al. Clinical profile of patients with nonarteritic anterior ischemic optic neuropathy presented to a referral center from 2003 to 2008[J]. Arch Iran Med, 2009, 12(5): 472-477.
9.	Jonas JB, Hayreh SS, Tao Y, et al. Optic nerve head change in non-arteritic anterior ischemic optic neuropathy and its influence on visual outcome[J/OL]. PLoS One, 2012, 7(5):37499[2012-5-21]. http://www.journals.plos.org/plosone/article?id=10.1371/journal.pone.0037499..
10.	Beri M, Klugman MR, Kohler JA, et al. Anterior ischemic optic neuropathy. VII. Incidence of bilaterality and various influencing factors[J]. Ophthalmology, 1987, 94(8): 1020-1028.
11.	Buono LM, Foroozan R, Sergott RC, et al. Nonarteritic anterior ischemic optic neuropathy[J]. Curr Opin Ophthalmol, 2002, 13(6): 357-361.
12.	Mathews MK. Nonarteritic anterior ischemic optic neuropathy[J]. Curr Opin Ophthalmol, 2005, 16(6): 341-345.
13.	Fontal MR, Kerrison JB, Garcia R, et al. Ischemic optic neuropathy[J]. Semin Neurol, 2007, 27(3): 221-232.
14.	郝静, 崔广伟, 郑曰忠, 等.非动脉炎性前部缺血性视神经病变临床特征及相关因素分析[J].国际眼科杂志, 2013, 13(8): 1657-1659.
15.	Arnold AC, Costa RM, Dumitrascu OM. The spectrum of optic disc ischemia in patients younger than 50 years (an Amercian Ophthalmological Society thesis)[J]. Trans Am Ophthalmol Soc, 2013, 9(111): 93-118.
16.	Hayreh SS, Zimmerman MB. Incipient nonarteritic anterior ischemic optic neuropathy[J]. Ophthalmology, 2007, 114(9): 1763-1772.
17.	Miller NR. Current concepts in the diagnosis, pathogenesis, and management of nonarteritic anterior ischemic optic neuropathy[J]. J Neuroophthalmol, 2011, 31(2):1-3.
18.	Chen T, Song D, Shan G, et al. The Association between diabetes mellitus and nonarteritic anterior ischemic optic neuropathy: a systematic review and meta-analysis[J/OL]. PLoS One, 2013, 8(9): 76653[2013-9-30]. http://www.journals.plos.org/plosone/article?id=10.1371/journal.pone.0076653.
19.	王小东, 王彤, 张德秀.非动脉炎性前部缺血性视神经病变与腹型肥胖的相关性研究[J].国际眼科杂志, 2011, 11(8): 1471-1472.
20.	Kosanovic-Jakovic N, Ivanovic B, Milenkovic S, et al. Anterior ischemic optic neuropathy associated with metabolic syndrome[J]. Arq Bras Oftalmol, 2008, 71(1): 62-66.
21.	Hayreh SS, Jonas JB, Zimmerman MB. Nonarteritic anterior ischemic optic neuropathy and tobacco smoking[J]. Ophthalmology, 2007, 114(4): 804-809.

1. Papchenko T, Grainger BT, Savino PJ, et al. Macular thickness predictive of visual field sensitivity in ischaemic optic neuropathy[J]. Acta Ophthalmol, 2012, 90(6): 463-469.
2. Carter JE. Anterior ischemic optic neuropathy and stroke with use of PDE-5 inhibitors for erectile dysfunction: cause or coincidence?[J]. J Neurol Sci, 2007, 262(1-2): 89-97.
3. Levin LA, Louhab A. Apoptosis of retinal ganglion cells in anterior ischemic optic neuropathy[J]. Arch Ophthalmol, 1996, 114(4): 488-491.
4. 陈婷, 马瑾, 钟勇.非动脉炎性前部缺血性视神经病变危险因素的研究进展[J].中华眼科杂志, 2013, 49(11): 1049-1051.
5. Miller NR, Arnold AC. Current concepts in the diagnosis, pathogenesis and management of nonarteritic anterior ischaemic optic neuropathy[J]. Eye (Lond), 2015, 29(1): 65-79.
6. Morris PB, Ference BA, Jahangir E, et al. Cardiovascular effects of exposure to cigarette smoke and electronic cigarettes: clinical perspectives from the prevention of cardiovascular disease section leadership council and early career councils of the American College of Cardiology[J]. J Am Coll Cardiol, 2015, 66(12): 1378-1391.
7. 田国红, 贾楠, 陆长峰, 等.非动脉炎性前部缺血性视神经病变的临床特征分析[J].中华眼科杂志, 2009, 45(12): 1064-1067.
8. Falavarjani KG, Sanjari MS, Modarres M, et al. Clinical profile of patients with nonarteritic anterior ischemic optic neuropathy presented to a referral center from 2003 to 2008[J]. Arch Iran Med, 2009, 12(5): 472-477.
9. Jonas JB, Hayreh SS, Tao Y, et al. Optic nerve head change in non-arteritic anterior ischemic optic neuropathy and its influence on visual outcome[J/OL]. PLoS One, 2012, 7(5):37499[2012-5-21]. http://www.journals.plos.org/plosone/article?id=10.1371/journal.pone.0037499..
10. Beri M, Klugman MR, Kohler JA, et al. Anterior ischemic optic neuropathy. VII. Incidence of bilaterality and various influencing factors[J]. Ophthalmology, 1987, 94(8): 1020-1028.
11. Buono LM, Foroozan R, Sergott RC, et al. Nonarteritic anterior ischemic optic neuropathy[J]. Curr Opin Ophthalmol, 2002, 13(6): 357-361.
12. Mathews MK. Nonarteritic anterior ischemic optic neuropathy[J]. Curr Opin Ophthalmol, 2005, 16(6): 341-345.
13. Fontal MR, Kerrison JB, Garcia R, et al. Ischemic optic neuropathy[J]. Semin Neurol, 2007, 27(3): 221-232.
14. 郝静, 崔广伟, 郑曰忠, 等.非动脉炎性前部缺血性视神经病变临床特征及相关因素分析[J].国际眼科杂志, 2013, 13(8): 1657-1659.
15. Arnold AC, Costa RM, Dumitrascu OM. The spectrum of optic disc ischemia in patients younger than 50 years (an Amercian Ophthalmological Society thesis)[J]. Trans Am Ophthalmol Soc, 2013, 9(111): 93-118.
16. Hayreh SS, Zimmerman MB. Incipient nonarteritic anterior ischemic optic neuropathy[J]. Ophthalmology, 2007, 114(9): 1763-1772.
17. Miller NR. Current concepts in the diagnosis, pathogenesis, and management of nonarteritic anterior ischemic optic neuropathy[J]. J Neuroophthalmol, 2011, 31(2):1-3.
18. Chen T, Song D, Shan G, et al. The Association between diabetes mellitus and nonarteritic anterior ischemic optic neuropathy: a systematic review and meta-analysis[J/OL]. PLoS One, 2013, 8(9): 76653[2013-9-30]. http://www.journals.plos.org/plosone/article?id=10.1371/journal.pone.0076653.
19. 王小东, 王彤, 张德秀.非动脉炎性前部缺血性视神经病变与腹型肥胖的相关性研究[J].国际眼科杂志, 2011, 11(8): 1471-1472.
20. Kosanovic-Jakovic N, Ivanovic B, Milenkovic S, et al. Anterior ischemic optic neuropathy associated with metabolic syndrome[J]. Arq Bras Oftalmol, 2008, 71(1): 62-66.
21. Hayreh SS, Jonas JB, Zimmerman MB. Nonarteritic anterior ischemic optic neuropathy and tobacco smoking[J]. Ophthalmology, 2007, 114(4): 804-809.

Chinese Journal of Ocular Fundus Diseases

Clinical profile and risk factors of non-arteritic anterior ischemic optic neuropathy

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