J Korean Ophthalmol Soc.  2007 Nov;48(11):1527-1531.

Risk Factors for Korean Patients with Anterior Ischemic Optic Neuropathy

Affiliations
  • 1i Clinic, Gwangju, Korea. eyelovehyun@hanmail.net
  • 2Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Sungnam, Korea.

Abstract

PURPOSE: To analyze the risk factors of Korean patients with anterior ischemic optic neuropathy (AION).
METHODS
Medical records of 48 Korean patients (24 men, 24 women) who were diagnosed as having AION were retrospectively reviewed and the risk factors of AION including age, sex, associated systemic disease, past medical history, social history, hematologic findings, 24-hour blood pressure monitoring, and optic disc of the clinically normal fellow eye, were analyzed.
RESULTS
The mean age of the 48 patients was 59.4 years (range, 36~80 years). There were 6 patients (12.5%) less than 45 years of age, 18 patients (37.5%) of 45 to 65 years of age, and 24 patients (50.0%) more than 65 years of age. There were 29 patients (60.4%) with associated systemic diseases such as hypertension (65.5%), diabetes mellitus, cerebrovascular disease, migraine, and heart disease with a decreasing order. Nine patients (18.8%) with a mean age of 50.6 years were smoker. Four patients developed AION after a cataract operation. There were 17 (68.0%) out of 25 patients with an increased level of cholesterol. Four patients whose 24-hour blood pressure was monitored showed that their blood pressure in night was lower than that in the day time. A cup disc ratio less than 0.2 was observed in 28 contralateral eyes (68.3%) of 41 patients with unilateral AION.
CONCLUSIONS
Hypertension, high cholesterol and decreased cup-to-disc ratio were observed in more than 60% of the Korean patients with AION, thereby composed the major risk factors.

Keyword

Anterior ischemic optic neuropathy; Cholesterol; Hypertension; Disc shape; Risk factors

MeSH Terms

Blood Pressure
Blood Pressure Monitors
Cataract
Cholesterol
Diabetes Mellitus
Heart Diseases
Humans
Hypertension
Male
Medical Records
Migraine Disorders
Optic Neuropathy, Ischemic*
Retrospective Studies
Risk Factors*
Cholesterol

Reference

References

1. Beri M, Klugman MR, Kohler JA, Hayreh SS. Anterior ischemic optic neuropathy. VII. Incidence of bilaterality and various influencing factors. Ophthalmology. 1987; 94:1020–8.
2. Hayreh SS, Joos KM, Podhajsky PA, Long CR. Systemic diseases associated with nonarteritic anterior ischemic optic neuropathy. Am J Ophthalmol. 1994; 118:766–80.
Article
3. Hayreh SS, Patricia A, Podhajsky P, Zimmerman MB. Nonarteritic anterior ishemic optic neuropathy: time of onset of visual loss. Am J Ophthalmol. 1997; 124:641–7.
4. Ellenberger C Jr.Ishemic optic neuropathy as a possible early complication of vascular hypertension. Am J Ophthalmol. 1979; 88:1045–51.
5. Begg IS, Drance SM, Sweeney VP. Ischemic optic neuropathy in chronic simple glaucoma. Br J Ophthalmol. 1971; 55:73–90.
6. Tomsak RL, Remler BF. Anterior ischemic optic neuropathy and increased intraocular pressure. J Clin Neuroophthalmol. 1989; 9:116–8.
7. Beck RW, Savino PJ, Repka MX, et al. Optic disc structure in anterior ischemic optic neuropathy. Ophthalmology. 1984; 91:1334–7.
Article
8. Doro S, Lessell S. Cup-disc ratio and ischemic optic neuropathy. Arch Ophthalmol. 1985; 103:1143–4.
Article
9. Feit RH, Tomsak RL, Ellenberger C Jr. Structural factors in the pathogenesis of ischaemic optic neuropathy. Am J Ophthalmol. 1984; 98:105–8.
10. Guyer DR, Miller NR, Auer CL, Fine SL. The risk of cerebrovascular and cardiovascular disease in patients with anterior ischemic optic neuropathy. Arch Ophthalmol. 1985; 103:1136–42.
Article
11. Ischemic Optic Neuropathy Decompression Trial Reaearch Group. Optic nerve decompression surgery for nonarteritic anterior ischemic optic neuropathy (NAION) is not effective and may be harmful. JAMA. 1995; 272:625–32.
12. Jun BK, Kim DS, Ko MK. Clinical features in anterior ischemic optic neuropathy. J Korean Ophthalmol Soc. 1999; 40:222–9.
13. Park WC, Chang BL. Clinical features of anterior ischemic optic neuropathy. J Korean Ophthalmol Soc. 2003; 44:144–9.
14. Hayreh SS, Zimmerman MB, Podhajsky P, Alward WLM. Nocturnal arterial hypotension and its role in optic nerve head and ocular ischemic disorders. Am J Ophthalmol. 1994; 117:603–24.
Article
15. Hayreh SS. Anterior ischemic optic neuropathy. Arch Neurol. 1981; 38:675–8.
Article
16. Landau K, Winterkorn JM, Mailloux LU, et al. 24-hour blood pressure monitoring in patients with anterior ischemic optic neuropathy. Arch Ophthalmol. 1996; 114:570–5.
Article
17. FizGerald GA, Oates JA, Nowak J. Cigarette smoking and hemostatic function. Am Heart J. 1988; 115:267–71.
18. Chung SM, Gay CA, McCrary JA 3rd. Nonarteritic ischemic optic neuropathy. The impact of tobacco use. Ophthalmology. 1994; 101:779–82.
19. McCulley TJ, Lam BL, Feuer WJ. Nonarteritic anterior ischemic optic neuropathy and surgery of the anterior segment: temporal relationship analysis. Am J Ophthalmol. 2003; 136:1171–2.
Article
20. Carroll FD. Optic nerve complications of cataract extraction. Trans Am Acad Ophthalmol Otolaryngol. 1973; 77:623–9.
21. McCulley TJ, Lam BL, Feuer WJ. Incidence of nonarteritic anterior ischemic optic neuropathy associated with cataract extraction. Ophthalmology. 2001; 108:1275–8.
22. Bochert M, Lessell S. Progressive and recurrent nonarteritic anterior ischemic optic neuropathy. Am J Ophthalmol. 1988; 106:443–9.
23. Hayreh SS. Anterior ischemic optic neuropathy, differentiation of arteritic from nonarteritic type and its management. Eye. 1990; 4:25–41.
24. Hayreh SS, Podhajsky PA, Zimmerman B. Occult giant cell arteritis: ocular manifestation. Am J Ophthalmol. 1998; 125:521–6.
25. Hayreh SS. Pathogenesis of cupping of the optic disc. Br J Ophthalmol. 1974; 58:863–75.
Article
26. Beck RW, Servais GE, Hayreh SS. Anterior ischemic optic neuropathy. IX. cup-to-disc ratio and its role in pathogenesis. Ophthalmology. 1987; 94:1503–8.
27. Duke-Elder S. System of Ophthalmology. 3rd ed.III. St Louis: CV Mosby;1963. p. 109–10.
28. McLeod D, Marshall J, Kohner EM. Role of axoplasmic transport in the pathophysiology of ischemic disc swelling. Br J Ophthalmol. 1980; 64:247–61.
Full Text Links
  • JKOS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr