Jacobson D M, Vierkant R A, Belongia E A
Department of Neurology, Marshfield Clinic, Wis., USA.
Arch Ophthalmol. 1997 Nov;115(11):1403-7. doi: 10.1001/archopht.1997.01100160573008.
To determine the influence of certain potential risk factors on the occurrence of nonarteritic anterior ischemic optic neuropathy.
Case-control using 2 independent control groups, one involving a geographically defined population and the other involving patients who underwent a routine comprehensive medical evaluation.
Multispecialty clinic in a rural setting providing primary, secondary, and tertiary care for residents of central and northern Wisconsin and the Upper Peninsula of Michigan.
Fifty-one patients older than 45 years with first ever acute nonarteritic anterior ischemic optic neuropathy.
Potential risk factors defined using standardized definitions abstracted from the medical records, including diabetes, hypertension, hypercholesterolemia, coronary artery disease, tobacco use, chronic obstructive pulmonary disease, body mass index, hematocrit, and white blood cell count.
Conditional logistic regression analyses, first using a univariate analysis and then employing a multivariate analysis using a forward selection process.
The geographically defined case-control multivariate analysis revealed that diabetes (odds ratio = 2.7, 95% confidence interval = 1.2-6.3, P = .02) and body mass index (odds ratio = 1.07, 95% confidence interval = 1.00-1.14, P = .08) were associated with case status. The comprehensive case-control multivariate analysis revealed that only diabetes (odds ratio = 5.0, 95% confidence interval = 1.4-17.3, P = .01) was a significant risk factor. The attributable risk estimation for diabetes was 0.21 and 0.27 for the geographically defined and comprehensive controls, respectively.
Diabetes seems to be a major risk factor for the development of nonarteritic anterior ischemic optic neuropathy. The low attributable risk estimation suggests that factors other than diabetes are important in the development of nonarteritic anterior ischemic optic neuropathy or in predisposing individuals to it.
确定某些潜在风险因素对非动脉炎性前部缺血性视神经病变发生的影响。
采用两个独立对照组的病例对照研究，一组涉及按地理位置界定的人群，另一组涉及接受常规全面医学评估的患者。
位于乡村的多专科诊所，为威斯康星州中部和北部以及密歇根州上半岛的居民提供初级、二级和三级护理。
51例年龄大于45岁的首次发生急性非动脉炎性前部缺血性视神经病变的患者。
使用从病历中提取的标准化定义确定的潜在风险因素，包括糖尿病、高血压、高胆固醇血症、冠状动脉疾病、吸烟、慢性阻塞性肺疾病、体重指数、血细胞比容和白细胞计数。
条件逻辑回归分析，首先进行单变量分析，然后采用向前选择法进行多变量分析。
按地理位置界定的病例对照多变量分析显示，糖尿病（比值比=2.7，95%置信区间=1.2 - 6.3，P = 0.02）和体重指数（比值比=1.07，95%置信区间=1.00 - 1.14，P = 0.08）与病例状态相关。全面病例对照多变量分析显示，只有糖尿病（比值比=5.0，95%置信区间=1.4 - 17.3，P = 0.01）是显著的风险因素。糖尿病的归因风险估计在按地理位置界定的对照组和全面对照组中分别为0.21和0.27。
糖尿病似乎是非动脉炎性前部缺血性视神经病变发生的主要风险因素。较低的归因风险估计表明，除糖尿病外的其他因素在非动脉炎性前部缺血性视神经病变的发生或使个体易患该病方面也很重要。
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