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Rong-Kung Tsai, Yueh-Chang Lee, Jen-Hung Wang, Tzu Lun Huang; Risk of Stroke in Patients with NAION: A Nationwide Retrospective Cohort Study. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5087.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the incidence and prevalence of nonarteritic anterior ischemic optic neuropathy (NAION) and extrapolate the risk of cerebrovascular events following NAION compared to an age- and gender-matched reference group.
Retrospective cohort study design. The study cohort was comprised of patients diagnosed with NAION seeking ambulatory care from 2000 to 2011. The comparison cohort was extracted from a subset of the National Health Insurance Research Database of Taiwan by randomly selecting two patients for every NAION patient, matched by age and gender. Cox proportional hazard regression analysis was performed to calculate adjusted odds ratios for the two cohorts. Subgroup analyses between subjects without or without comorbidities of NAION and comparison cohorts were conducted.
Four hundred and fourteen patients were included in the study cohort and 789 in the control group. The mean follow-up period was 5.9 years. The incidence of NAION was 3.72/100,000 person-years, and prevalence of NAION was 48.18/100,000 persons in Taiwan. The NAION group was more likely to have any stroke (adjusted hazard ratio (aHR) = 1.93, p = 0.002) and ischemic stroke (aHR = 2.03, p = 0.003), but not hemorrhagic stroke (aHR = 1.24, p = 0.696) than the comparison group. Among the subgroup with comorbidities , the odds of ischemic stroke among the subjects with NAION were 3.35 times higher than for those without NAION (95% CI: 1.67, 6.70).
The incidence of NAION in Taiwan is 3.72/100,000 person-years. The NAION group had an increased risk of ischemic stroke and all stroke. Physicians should refer all patients with NAION for systemic vasculopathy examinations and control of modifiable risk factors to prevent irreversible neurological sequelae.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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