Evidence of nocturnal hypotension in an inpatient prior to an episode of classic NAION

Melachuri, Samyuktha; Lim, Chae Hee; Winters, Jacob

doi:10.1016/j.jcjo.2022.02.016

Cited by 2 publications

(4 citation statements)

References 2 publications

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“…Finally, patients with hypotension were also found to have significantly higher odds of developing NAION than controls (adjusted OR = 2.32, 95% CI = 1.31-4.10, p = 0.0039). The relationship between NAION and hypotension has been documented in several studies involving nocturnal hypotension [24,25], haemodialysis-related hypotension [18,23], and hypotension after orthopaedic surgery [20][21][22]. Hayreh et al hypothesised that perfusion to the optic disc may be impaired by nocturnal hypotension, leading to NAION, especially in patients with vascular risk factors (particularly hypertension and diabetes) [24,25].…”

Section: Discussionmentioning

confidence: 99%

“…The relationship between NAION and hypotension has been documented in several studies involving nocturnal hypotension [24,25], haemodialysis-related hypotension [18,23], and hypotension after orthopaedic surgery [20][21][22]. Hayreh et al hypothesised that perfusion to the optic disc may be impaired by nocturnal hypotension, leading to NAION, especially in patients with vascular risk factors (particularly hypertension and diabetes) [24,25]. Donaldson et al reported a case series revealing the association between intradialytic hypotension and NAION and suggested that intradialytic blood pressure and fluid balance must be closely monitored to prevent hypotension that can cause ischaemia to the optic nerves [18,23].…”

Section: Discussionmentioning

confidence: 99%

“…The pathogenesis of NAION is believed to be multifactorial and mainly results from non-perfusion or hypoperfusion of the optic nerve head, which could be the consequence of a small and crowded optic disc, decreased blood oxygen carrying capacity, low blood delivery, or increased vascular resistance [1-3, 6, 9]. Previous studies have elicited many potential risk factors including the anatomic predisposition of a "crowded" optic disk [10,11], diabetes mellitus (DM) [12][13][14][15][16], hypertension [15][16][17], hyperlipidaemia [14][15][16], chronic kidney disease (CKD) [18,19], and hypotension [18,[20][21][22][23][24][25].…”

Section: Introductionmentioning

confidence: 99%

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A Taiwan Nationwide Population-Based Study of Socio-Demographic Factors and Comorbid Conditions Associated with Non-Arteritic Anterior Ischaemic Optic Neuropathy

Jan

Wang

et al. 2022

Neuroepidemiology

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Aims: To investigate the socio-demographic factors and systemic conditions associated with non-arteritic anterior ischaemic optic neuropathy (NAION). Methods: This was a nationwide population-based retrospective case-controlled study that recruited 9,261 NAION patients selected from the Taiwan National Health Insurance Research Database. The control group consisted of 9,261 age-, sex-, and index date-matched non-NAION patients recruited from the Taiwan Longitudinal Health Insurance Database, 2000. NAION was designated in the database by the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) as “code 377.41: ischaemic optic neuropathy without ICD-9-CM code 446.5: giant cell arteritis”. Associated socio-demographic factors and systemic medical conditions were analysed using the McNemar’s test, and continuous variables were analysed using the paired t-test. The odds ratio (OR) and adjusted OR of developing NAION were compared using univariate logistic regression and multivariable logistic regression analyses, respectively. Results: Patients with systemic conditions such as diabetes mellitus, hypertension, hyperlipidaemia, chronic kidney disease, and hypotension were more likely to develop NAION than controls (adjusted OR=1.81, 95% CI=1.67–1.97, p<0.0001; adjusted OR=1.46, 95% CI=1.36–1.57, p<0.0001; adjusted OR=1.44, 95% CI=1.33–1.57, p<0.0001; adjusted OR=3.26, 95% CI=2.65–4.01, p<0.0001; adjusted OR=2.32, 95% CI=1.31–4.10, p=0.0039, respectively). Patients residing in Eastern Taiwan or in a metropolitan city had higher odds of developing NAION. Patients with a monthly income between NT$ 30,000 and NT$ 90,000 and those whose jobs were others also had significantly higher ORs of developing NAION. Conclusions: NAION is strongly associated with diabetes mellitus, hypertension, hyperlipidaemia, chronic kidney disease, and hypotension.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Taiwan Nationwide Population-Based Study of Socio-Demographic Factors and Comorbid Conditions Associated with Non-Arteritic Anterior Ischaemic Optic Neuropathy

Jan

Wang

et al. 2022

Neuroepidemiology

View full text Add to dashboard Cite

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“…N on-arteritic anterior ischaemic optic neuropathy (NAION) is a common acute optic nerve damage disease with 2.5-11.8/100 000 incidence in people over 50 years old [1] . Based on existing research findings, common risk factors of NAION include systemic factors such as hypertension, diabetes, hyperlipidemia [2][3] , nocturnal arterial hypotension, and obstructive sleep apnea syndrome [4][5] . The anatomical structure of the small optic disc, small cup-todisc ratio (C/D), small optic cup, or ignoring cup may be local risk factors for NAION [6][7] .…”

Section: Introductionmentioning

confidence: 99%

Risk factors of non-arteritic anterior ischaemic optic neuropathy and central retinal artery occlusion

Ma,

Dai,

Chen

et al. 2024

Int J Ophthalmol

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AIM: To investigate the difference in risk factors between non-arteritic anterior ischaemic optic neuropathy (NAION) and central retinal artery occlusion (CRAO) and develop a predictive diagnostic nomogram. METHODS: The study included 37 patients with monocular NAION, 20 with monocular CRAO, and 24 with hypertension. Gender, age, and systemic diseases were recorded. Blood routine, lipids, hemorheology, carotid and brachial artery doppler ultrasound, and echocardiography were collected. The optic disc area, cup area, and cup-to-disc ratio (C/D) of the unaffected eye in the NAION and CRAO group and the right eye in the hypertension group were measured. RESULTS: The carotid artery intimal medial thickness (C-IMT) of the affected side of the CRAO group was thicker (P=0.039) and its flow-mediated dilation (FMD) was lower (P=0.049) than the NAION group. Compared with hypertension patients, NAION patients had higher whole blood reduced viscosity low-shear (WBRV-L) and erythrocyte aggregation index (EAI; P=0.045, 0.037), and CRAO patients had higher index of rigidity of erythrocyte (IR) and erythrocyte deformation index (EDI; P=0.004, 0.001). The optic cup and the C/D of the NAION group were smaller than the other two groups (P<0.0001). The diagnostic prediction model showed high diagnostic specificity (83.7%) and sensitivity (85.6%), which was highly related to hypertension, the C-IMT of the affected side, FMD, platelet (PLT), EAI, and C/D. CONCLUSION: CRAO patients show thicker C-IMT and worse endothelial function than NAION. NAION and CRAO may be related to abnormal hemorheology. A small cup and small C/D may be involved in NAION. The diagnostic nomogram can be used to preliminarily identify NAION and CRAO.

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Evidence of nocturnal hypotension in an inpatient prior to an episode of classic NAION

Cited by 2 publications

References 2 publications

A Taiwan Nationwide Population-Based Study of Socio-Demographic Factors and Comorbid Conditions Associated with Non-Arteritic Anterior Ischaemic Optic Neuropathy

A Taiwan Nationwide Population-Based Study of Socio-Demographic Factors and Comorbid Conditions Associated with Non-Arteritic Anterior Ischaemic Optic Neuropathy

Risk factors of non-arteritic anterior ischaemic optic neuropathy and central retinal artery occlusion

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