Lin Ting-Yi, Lai Yi-Fen, Chen Po-Huang, Chung Chi-Hsiang, Chen Ching-Long, Chen Yi-Hao, Chen Jiann-Torng, Kuo Po-Chen, Chien Wu-Chien, Hsieh Yun-Hsiu
Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan.
Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan.
Front Med (Lausanne). 2021 Sep 28;8:753367. doi: 10.3389/fmed.2021.753367. eCollection 2021.
Ischemic optic neuropathy (ION) is a possible extraintestinal manifestation (EIM) of inflammatory bowel disease (IBD). We investigate the relation between IBD and ION and possible risk factors associated with their incidence. Medical records were extracted from the National Health Insurance Research Database (NHIRD) from January 1, 2000, to December 31, 2013. The main outcome was ION development. Univariate and multivariate Cox regression analyses were performed. We enrolled 22,540 individuals (4,508 with IBD, 18,032 without). The cumulative risk of developing ION was significantly greater for patients with IBD vs. patients without (Kaplan-Meier survival curve, = 0.009; log-rank test). Seven (5%) and five (0.03%) patients developed ION in the IBD and control groups, respectively. Patients with IBD were significantly more likely to develop ION than those without IBD [adjusted hazard ratio (HR) = 4.135; 95% confidence interval: 1.312-11.246, = 0.01]. Possible risk factors of ION development were age 30-39 years, diabetes mellitus (DM), hypertension, ischemic heart disease (IHD), atherosclerosis, and higher Charlson comorbidity index revised (CCI_R) value. Patients with IBD are at increased risk of subsequent ION development. Moreover, for patients with comorbidities, the risk of ION development is significantly higher in those with IBD than in those without.
缺血性视神经病变（ION）是炎症性肠病（IBD）一种可能的肠外表现（EIM）。我们研究IBD与ION之间的关系以及与其发病率相关的可能危险因素。从2000年1月1日至2013年12月31日的国民健康保险研究数据库（NHIRD）中提取医疗记录。主要结局是ION的发生。进行单因素和多因素Cox回归分析。我们纳入了22540名个体（4508名患有IBD，18032名未患）。IBD患者发生ION的累积风险显著高于未患IBD的患者（Kaplan-Meier生存曲线，P = 0.009；对数秩检验）。IBD组和对照组分别有7名（5%）和5名（0.03%）患者发生ION。IBD患者比未患IBD的患者更易发生ION [调整后风险比（HR）= 4.135；95%置信区间：1.312 - 11.246，P = 0.01]。ION发生的可能危险因素为年龄30 - 39岁、糖尿病（DM）、高血压、缺血性心脏病（IHD）、动脉粥样硬化以及更高的修订Charlson合并症指数（CCI_R）值。IBD患者发生后续ION的风险增加。此外，对于患有合并症的患者，IBD患者发生ION的风险显著高于未患IBD的患者。
