Clinical characteristics of acute ischemic retinopathy and nonarteritic anterior ischemic optic neuropathy

Abstract

To compare the vascular risk factors between acute ischemic retinopathy (AIR) and nonarteritic anterior ischemic optic neuropathy (NAION). Single center retrospective study. Patients diagnosed of AIR and NAION from Jan 2008 to Jan 2009 in Beijing Tongren hospital were enrolled in this study. The demographical data, the results of blood tests, cardiac examinations, carotid vascular ultrasound and brain MRI were analyzed by Chi-square test. Ninety-one AIR patients and 143 NAION patients were enrolled. The mean age of the NAION patients (51.4 ± 8.9) was lower than that of the AIR group (55.4 ± 15.8) (t = 2.514, P = 0.013). There was no significant difference in the gender, smoking status, hypertension and fasting blood glucose levels between these two groups (χ(2) = 0.023, 2.727, 0.217, 0.012; all P > 0.05). The percentage of hypercholesterolemia (total cholesterol > 5.17 mmol/L) was 46.2% (66/143) in the NAION group and 26.4% (24/91) in the AIR group (χ(2) = 9.193, P = 0.002). Prevalence of carotid artery disease and ischemic heart disease was 13.2% (12/91) in the AIR group and 4.9% (7/143) in the NAION group (χ(2) = 5.125, P = 0.024). Carotid artery stenosis was present in 34.5% (30/87) patients in the AIR group, whereas none in the NAION group (χ(2) = 44.370, P = 0.000). Among 57 AIR patients and 127 NAION patients who finished brain MRI, the percentage of cerebral infarction was 47.4% (27/57) in the AIR group and 0.8% (1/127) in the NAION group (χ(2) = 66.210, P = 0.000). Cerebral white matter hyperintensities (WMH) were present in 66.9% (85/127) of the NAION group and 36.8% (21/57) in the AIR group (χ(2) = 66.46, P = 0.000). The mean age of NAION patients was lower than that of the AIR patients. Carotid artery stenosis and stroke, which might indicate large-middle vessel disease, are common in ischemic retinopathy. WMH with small vascular atherosclerosis, possibly caused by hypercholesterolemia, is more common in the NAION group.