Analysis of prothrombotic and vascular risk factors in patients with nonarteritic anterior ischemic optic neuropathy

Ophthalmology. 1999 Apr;106(4):739-42. doi: 10.1016/S0161-6420(99)90159-8.


Objective: To determine whether genetic or acquired thrombophilias and other risk factors are associated with nonarteritic anterior ischemic optic neuropathy (NAION).

Design: Retrospective case-control study.

Participants: Sixty-one patients with NAION diagnosed between 1984 and 1997. Ninety consecutive patients who visited the Eye Institute made up the control group.

Intervention: Protein C, protein S, antithrombin III, lupus anticoagulant, and three recently described prothrombotic polymorphisms (i.e., factor V G1691A, factor II G20210A, and methylenetetrahydrofolate reductase [MTHFR] C677T) were analyzed. In addition, risk factors for arteriosclerotic vascular disease were assessed.

Main outcome measures: Parameters of thrombophilia.

Results: None of the thrombophilic markers (genetic and acquired) constituted a significant risk factor for NAION. Ischemic heart disease, hypercholesterolemia, and diabetes mellitus were discerned as risk factors for NAION with odds ratios of 2.9 (95% confidence interval [CI], 1.3-6.4), 2.6 (95% CI, 1.2-5.5), and 2.3 (95% CI, 1.1-4.8), respectively. Multiple logistic regression analysis indicated that ischemic heart disease and hypercholesterolemia exerted an additive risk for NAION with a combined odds ratio of 4.5 (95% CI, 1.4-14.5). However, none of these risk factors statistically predicted second eye involvement.

Conclusion: NAION was not found to be associated with thrombophilic risk factors, yet it was related to ischemic heart disease, hypercholesterolemia, and diabetes mellitus.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Arteritis
  • Biomarkers
  • Case-Control Studies
  • Diabetes Complications*
  • Female
  • Humans
  • Hypercholesterolemia / complications*
  • Male
  • Middle Aged
  • Myocardial Ischemia / complications*
  • Odds Ratio
  • Optic Disk / blood supply
  • Optic Neuropathy, Ischemic / blood
  • Optic Neuropathy, Ischemic / etiology*
  • Prothrombin / analysis*
  • Retrospective Studies
  • Risk Factors
  • Thrombophilia / blood
  • Thrombophilia / complications


  • Biomarkers
  • Prothrombin