Risk of Stroke After Nonarteritic Anterior Ischemic Optic Neuropathy

Abstract

Purpose: To determine whether nonarteritic ischemic optic neuropathy (NAION) raises the risk of subsequent stroke in the general population.

Design: Population-based, retrospective cohort study.

Methods: Setting: Nationwide, population-based, retrospective cohort study.

Patients: Of 1 025 340 beneficiaries in the National Health Insurance Service-National Sample Cohort database (2002-2013), we included 400 952 eligible individuals in the analysis.

Observations: To determine the effect of incident NAION on the occurrence of subsequent stroke, we used time-varying covariate Cox regression models. Model 1 included only incident NAION as a time-varying covariate. Model 2 included Model 1 and defined demographics. Model 3 included Model 2, comorbidity, co-medication, and Charlson index score.

Main outcome measures: Effect (hazard ratio [HR]) of NAION on stroke development.

Results: Of 400 952 eligible individuals, 1125 patients developed NAION and 16 998 patients suffered from stroke. NAION was not associated with an increased risk of subsequent stroke in Model 1, with HR of 1.31 (95% confidence interval [CI], 0.89-1.92). This was consistent, after adjusting for demographics and/or confounding factors, in Model 2 (HR = 1.19, 95% CI, 0.81-1.75) and Model 3 (HR = 1.10, 95% CI, 0.75-1.62).

Conclusions: Our results suggest that NAION per se is not associated with a subsequent risk of stroke in the general population.