Han Xu, Li Hongyang, Meng Zhaoyang, Wang Yanling
Department of Ophthalmology, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Front Neurol. 2024 Nov 15;15:1400452. doi: 10.3389/fneur.2024.1400452. eCollection 2024.
The study aims to determine the correlation between cerebral small vessel diseases (SVDs) and nonarteritic anterior ischemic optic neuropathy (NAION). Additionally, investigate whether NAION raises the risk of an increased total cerebral small vessel disease score (CSVD score) compared to control group without ocular conditions.
101 controls without any retinal illness and 61 individuals with NAION were enrolled for this retrospective case control study. Ophthalmic examinations and brain magnetic resonance imaging (MRI) scans were performed on all participants. Data on demographics and clinical characteristics were obtained from hospital medical records. We evaluated and compared the distribution of SVDs and rated the total CSVD score based on SVD indications observed on MRI scans.
SVDs were more frequently in NAION individuals than in control group (82%, < 0.001), and their odds ratio was 4.11 (95%CI: 1.93-8.79, < 0.001). The ordinal logistic regression showed patients in NAION group had 3.08-, 5.66- and 2.90-times higher risk than in control group, at each point of the white matter hyperintensity (WMH) score (95%CI: 1.43-6.79, = 0.003), perivascular spaces (PVS) score (95%CI: 2.31-14.9, < 0.001) and CSVD score (95%CI: 1.32-6.51, = 0.005) respectively. Dyslipidemia presented a higher risk in the presence of SVDs ( = 0.008, OR = 2.31, 95%CI: 1.20-4.44) and WHM score ( = 0.018, OR = 2.22, 95%CI: 1.07-4.70). There was no significant difference between NAION group and controls in sex, age, or other past medical characteristics.
The predictive effect of NAION on SVDs is possible as NAION patients have an increased risk with SVDs. Brain MRI scans and the control of risk factors associated with SVDs should be recommended for individuals who develop NAION.
本研究旨在确定脑小血管疾病（SVDs）与非动脉炎性前部缺血性视神经病变（NAION）之间的相关性。此外，研究与无眼部疾病的对照组相比，NAION是否会增加全脑小血管疾病评分（CSVD评分）升高的风险。
本回顾性病例对照研究纳入了101名无任何视网膜疾病的对照者和61名患有NAION的个体。对所有参与者进行眼科检查和脑磁共振成像（MRI）扫描。从医院病历中获取人口统计学和临床特征数据。我们评估并比较了SVDs的分布情况，并根据MRI扫描中观察到的SVD指征对CSVD总分进行评分。
NAION个体中SVDs的发生率高于对照组（82%，<0.001），其优势比为4.11（95%CI：1.93-8.79，<0.001）。有序逻辑回归显示，在白质高信号（WMH）评分的每个点上，NAION组患者的风险比对照组高3.08倍、5.66倍和2.90倍（95%CI：1.43-6.79，P = 0.003），在血管周围间隙（PVS）评分（95%CI：2.31-14.9，<0.001）和CSVD评分（95%CI：1.32-6.51，P = 0.005）方面亦是如此。在存在SVDs（P = 0.008，OR = 2.31，95%CI：1.20-4.44）和WMH评分（P = 0.018，OR = 2.22，95%CI：1.07-4.70）时，血脂异常呈现出更高的风险。NAION组与对照组在性别、年龄或其他既往病史特征方面无显著差异。
由于NAION患者发生SVDs的风险增加，因此NAION对SVDs可能具有预测作用。对于发生NAION的个体，建议进行脑MRI扫描并控制与SVDs相关的危险因素。
