Comparison of Visual Outcomes of Nonarteritic Anterior Ischemic Optic Neuropathy in Patients with and without Diabetes Mellitus

Sharma, Srilakshmi M; Kwan, Sarah; Fallano, Katherine; Wang, Jiangxia; Miller, Neil R.; Subramanian, Prem S.

doi:10.1016/j.ophtha.2016.11.029

Cited by 12 publications

(15 citation statements)

References 24 publications

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“…Particularly, AION subjects had the highest HDL value compared with the other three type of DON. Similarly, Sharma et al 22 also found that hyperlipidemia is a risk factor for AION in diabetic patients. Further research is needed to better understand the influences of both low-density lipoprotein and HDL on DON.…”

Section: Discussionmentioning

confidence: 84%

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Diabetic Optic Neuropathy and Its Risk Factors in Chinese Patients With Diabetic Retinopathy

Hua

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. To investigate diabetic optic neuropathy (DON) prevalence and risk factors in Chinese diabetic retinopathy (DR) patients. METHODS. This retrospective study included 1067 eyes (550 patients) that underwent ocular imaging. The diabetes duration, systolic blood pressure (SBP), hemoglobin A1c (HbA1c), and high-density lipoprotein (HDL) were also recorded simultaneously. RESULTS. A total of 410 eyes with DON and 657 eyes without DON were included (38.4% DON prevalence). DON eyes were classified as having diabetic papillopathy (DP), optic disc neovascularization (NVD), anterior ischemic optic neuropathy (AION), or optic atrophy (OA). Proliferative DR eyes had a higher DON prevalence than nonproliferative DR eyes (P < 0.001). Diabetes duration, SBP, and HbA1c were higher in DON patients than in non-DON patients (all P < 0.001). Additionally, HDL was lower in patients with DON (0.74 6 0.13 mM) than in those without DON (1.00 6 0.24 mM, P < 0.001). HbA1c levels were greater in AION patients (10.00 6 1.53% [85.76 6 16.71 mmol/mol]) than in DP patients (8.78 6 1.97% [72.45 6 21.55 mmol/mol], P ¼ 0.017); central foveal thickness (CFT) significantly varied among groups (P < 0.001). Increased age, diabetes duration, SBP, CFT, and DR severity were risk factors for DON; and increased HbA1c was a risk factor for NVD, AION, and OA (all P < 0.05). CONCLUSIONS. Our study results strengthen the argument that increased age, diabetes duration, SBP, CFT, DR severity, and HbA1c are all risk factors for DON in patients with DR.

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Section: Discussionmentioning

confidence: 84%

“…This finding is in agreement with another study that found hypertension to be a risk factor for AION in diabetic patients. 22 Plasma HbA1c and HDL levels may influence the development of DON. Subjects in the current study had a mean HbA1c of 8.42 6 1.72% (68.58 6 18.82 mmol/mol), indicating a moderate level of metabolic control.…”

Section: Discussionmentioning

confidence: 99%

Diabetic Optic Neuropathy and Its Risk Factors in Chinese Patients With Diabetic Retinopathy

Hua

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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“…The inclusion criteria were NAION patients diagnosed during the study period by ophthalmologists in our center based on the parameters used in the research by Sharma et al [7], which were as follows: acute painless visual loss with the evidence of optic neuropathy including the presence of RAPD; presenting a swelling disc morphology within one month; impaired color vision test; or nerve fiber layer defect on a visual field test. All patients underwent complete ophthalmic evaluations at the initial visit, one week, four weeks, and 12 weeks after onset duration, including best-corrected visual acuity (BCVA), color vision tested by Ishihara color plate, pupillary defect, fundus, and optic disc examination.…”

Section: Study Design and Data Collectionmentioning

confidence: 99%

“…Previous researchers have found systemic vascular diseases, such as type 2 diabetes mellitus (T2DM), hypertension (HT), dyslipidemia (DLP), and ischemic heart disease (IHD), to be risk factors for developing NAION [2][3][4][5]. Hayreh et al proposed that these vascular diseases did not affect visual outcomes [6]; however, Sharma et al observed that patients with IHD carried a higher risk of having worse final visual acuity [7]. In addition, Dattilo et al suggested that having multiple vascular diseases rendered patients in western countries prone to having a worse final vision [8].…”

Section: Introductionmentioning

confidence: 99%

Factors Associated With Visual Acuity in Non-arteritic Ischemic Optic Neuropathy Patients: A Five-Year Cross-Sectional Study

Kemchoknatee¹,

Singhakul²,

Tangon³

et al. 2022

Cureus

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Background and objectiveNon-arteritic ischemic optic neuropathy (NAION) is a common cause of optic neuropathy in elderly patients. Currently, there is no definitive treatment for this condition, and the factors influencing visual outcomes have not yet been conclusively identified. In this study, we aimed to evaluate factors that affect visual outcomes and those that are predictors of the development of NAION in a Thai population. MethodsAll patients diagnosed with NAION at the Rajavithi Hospital between January 1, 2016, and December 31, 2020, were retrospectively reviewed to evaluate the improvement in their best-corrected visual acuity (BCVA) and determine the factors that are predictive of visual outcomes. ResultsThe 80 patients reviewed were predominantly male (55%) with a mean age of 55.8 ±9.89 years. Their most common comorbidities were dyslipidemia (DLP) (67.5%), diabetes mellitus (DM) (61.3%), and hypertension (HT) (48.8%). At the 12-week follow-up visit, there was a significant improvement of at least 0.2 logarithm of the minimum angle of resolution (logMAR) in BCVA (p=0.001). A significantly greater percentage of patients with higher age, DM, and HT was observed in the unfavorable visual recovery (UVR) group (p=0.002, p=0.001, and p=0.005 respectively). In contrast, neither baseline visual acuity nor cup-to-disc ratio (CDR) affected the result of visual recovery (p=0.275 and p=0.076, respectively). In multivariate logistic analysis, older age increased the odds of worse visual recovery [odds ratio (

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“…Previous studies on mechanisms of pressure natriuresis have focused on the regulation of transcellular sodium transporters in the kidney [3, 4]. The results suggest that proximal tubule sodium transporters are not primarily involved [5], but have a compensatory action in response to changes in extracellular fluid volume and blood pressure.…”

Section: Introductionmentioning

confidence: 99%

Alteration of Tight Junction Protein Expression in Dahl Salt-Sensitive Rat Kidney

Kim

et al. 2017

Kidney Blood Press Res

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Background/Aims: Altered pressure natriuresis is an important mechanism of hypertension, but it remains elusive at the molecular level. We hypothesized that in the kidney, tight junctions (TJs) may have a role in pressure natriuresis because paracellular NaCl transport affects interstitial hydrostatic pressure. Methods: To assess the association of salt-sensitive hypertension with altered renal TJ protein expression, Dahl salt-sensitive (SS) and salt-resistant (SR) rats were put on an 8% NaCl-containing rodent diet for 4 weeks. Systolic blood pressure (SBP) and urine NaCl excretion were measured weekly, and kidneys were harvested for immunoblotting and quantitative PCR analysis at the end of the animal experiments. Results: SBP was significantly higher in SS rats than in SR rats during the first to fourth weeks of the animal experiments. During the first and second week, urinary NaCl excretion was significantly lower in SS rats as compared with SR rats. However, the difference between the two groups vanished at the third and fourth weeks. In the kidney, claudin-4 protein and mRNA were significantly increased in SS rats as compared with SR rats. On the other hand, occludin protein and mRNA were significantly decreased in SS rats as compared with SR rats. The expression of claudin-2, claudin-7, and claudin-8 did not vary significantly between the two groups. Conclusions: In SS rats, SS hypertension was associated with differential changes in renal TJ protein expression. Both upregulation of claudin-4 and downregulation of occludin might increase paracellular NaCl transport in the kidney, resulting in impaired pressure natriuresis in SS rats.

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Comparison of Visual Outcomes of Nonarteritic Anterior Ischemic Optic Neuropathy in Patients with and without Diabetes Mellitus

Cited by 12 publications

References 24 publications

Diabetic Optic Neuropathy and Its Risk Factors in Chinese Patients With Diabetic Retinopathy

Diabetic Optic Neuropathy and Its Risk Factors in Chinese Patients With Diabetic Retinopathy

Factors Associated With Visual Acuity in Non-arteritic Ischemic Optic Neuropathy Patients: A Five-Year Cross-Sectional Study

Alteration of Tight Junction Protein Expression in Dahl Salt-Sensitive Rat Kidney

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