Cardiometabolic factors and risk of non-arteritic anterior ischemic optic neuropathy: a systematic review and meta-analysis

Irini P Chatziralli; Dimitrios Kazantzis; Alexandros P Chatzirallis; Genovefa Machairoudia; Effie G Papageorgiou; George P Theodossiadis; Theodora Psaltopoulou; Panagiotis G Theodossiadis; Theodoros N Sergentanis

doi:10.1007/s00417-021-05522-4

Cardiometabolic factors and risk of non-arteritic anterior ischemic optic neuropathy: a systematic review and meta-analysis

Graefes Arch Clin Exp Ophthalmol. 2022 May;260(5):1445-1456. doi: 10.1007/s00417-021-05522-4. Epub 2022 Jan 24.

Authors

Irini P Chatziralli¹, Dimitrios Kazantzis², Alexandros P Chatzirallis³, Genovefa Machairoudia², Effie G Papageorgiou⁴, George P Theodossiadis², Theodora Psaltopoulou⁵, Panagiotis G Theodossiadis², Theodoros N Sergentanis^{4

5}

Affiliations

¹ 2nd Department of Ophthalmology, National and Kapodistrian University of Athens, 1, Rimini Street, Haidari, 12462, Athens, Greece. eirchat@yahoo.gr.
² 2nd Department of Ophthalmology, National and Kapodistrian University of Athens, 1, Rimini Street, Haidari, 12462, Athens, Greece.
³ 2nd Department of Ophthalmology, Ophthalmiatrion Athinon, Athens, Greece.
⁴ Department of Biomedical Sciences, University of West Attica, Athens, Greece.
⁵ Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.

PMID: 35067769
DOI: 10.1007/s00417-021-05522-4

Abstract

Purpose: The purpose of this systematic review and meta-analysis of the literature is to evaluate the association between cardiometabolic risk factors (hypertension, diabetes mellitus, hypercholesterolemia/dyslipidemia, HDL cholesterol, LDL cholesterol, lipoprotein(a), and triglycerides) and non-arteritic anterior ischemic optic neuropathy (NAION).

Methods: Pertinent publications were identified through a systematic search in PubMed and EMBASE databases, without language restrictions. The pooled odds ratios (OR) and standardized mean differences (SMD), with their 95% confidence intervals (95% CI) were estimated using random effects (DerSimonian Laird) models, as appropriate. A set of subgroup analyses and meta-regression analysis models were performed.

Results: Twenty-one studies (including 1560 patients with NAION and 2292 controls), examining the association between NAION and cardiometabolic risk factors, were eligible for the systematic review and meta-analysis. Hypertension (pooled OR = 1.50; 95% CI: 1.16-1.94), diabetes mellitus (pooled OR = 1.71; 95% CI: 1.33-2.21), and hypercholesterolemia/dyslipidemia (pooled OR = 2.00; 95% CI: 1.53-2.62) were associated with NAION. Among the components of dyslipidemia, higher serum triglycerides were associated with NAION, with a medium effect size (SMD = + 0.58, 95% CI: + 0.12 to + 1.04), whereas synthesis of four studies reporting on HDL and LDL cholesterol did not reveal any significant associations. A significant association between NAION and higher serum lipoprotein(a) levels (pooled OR = 2.88; 95%CI: 1.01-8.21) was also noted.

Conclusions: This systematic review and meta-analysis found that NAION was associated with cardiometabolic factors, suggesting that vascular dysfunction may be implicated in the pathogenesis of the disease. Our findings may alert health care providers to try modifying these risk factors for NAION prevention.

Keywords: Cardiometabolic; Diabetes mellitus; Dyslipidemia; Hypertension; Non-arteritic anterior ischemic optic neuropathy; Risk factors.

Publication types

Meta-Analysis
Review
Systematic Review

MeSH terms

Dyslipidemias* / complications
Dyslipidemias* / epidemiology
Humans
Hypercholesterolemia* / complications
Hyperlipidemias* / complications
Hypertension* / complications
Lipoprotein(a)
Optic Neuropathy, Ischemic* / diagnosis
Optic Neuropathy, Ischemic* / epidemiology
Optic Neuropathy, Ischemic* / etiology
Risk Factors
Triglycerides

Substances

Lipoprotein(a)
Triglycerides