Abstract:

Objective To compare the clinical characteristics and risk factors of unilateral and bilateral onset in non-arteritic anterior ischemic optic neuropathy (NAION) patients. Design Retrospective case series. Participants A total of 201 patients of NAION were recruited in Department of Ophthalmology of PLA General Hospital from October 2009 to March 2015. Methods Differences in clinical characteristics, including disease history, laboratory tests, carotid artery ultrasound, brain magnetic resonance imaging (MRI), polysomnography (PSG) and ambulatory blood pressure monitoring (ABPM), between groups were analyzed using Chi-square test or t-test. Main Outcome Measures Age, gender, systemic disease, medications taken and anatomy of optic disc. Results Among the 201 NAION patients, 67 patients were bilateral onset (6 of them happened bilaterally simultaneously or with an internal less than 1 week between the two eyes) and the other 134 patients were unilateral onset. There was no difference found between the two groups in age (54.69±10.43 vs 54.47±9.90 years old, P=0.988) and gender (Male: Female: 1.34:1 vs 2.05:1, P=0.22). Compare to the unilateral group, the bilateral group showed a higher percentage of hypertension (52.2% vs 37.3%, P=0.04), lower percentage of noctural hypotension (19.2% vs 37.2%, P=0.026), more frequent using of hypotensors (65.7% vs 40.3%, P=0.03) , more frequent coexisting with obstructive sleep apnea syndrome (OSAHS) (35.4% vs 21.2%, P=0.036), and more frequent of obesity(17.9% vs 9.7%, P=0.031). There were no significant differences in smoking and drinking status, diabetes, dyslipidemia, carotid atherosclerosis, cerebral infarction, homocysteine serum cystine, crowded disc, or precipitating factor. Conclusions Hypertension, hypotensive medications, obesity and coexist with OSAHS may be risk factors for the development of bilateral NAION. (Ophthalmol CHN, 2016, 25: 377-380)

Key words: ischemic optic neuropathy, risk factors