Do patients with NAION have an increased risk of stroke?

Nonarteritic anterior ischemic optic neuropathy (NAION) and stroke share common risk factors such as hypertension and diabetes, but the association between these 2 conditions remains controversial. Some previous studies have suggested a greater risk of ischemic stroke in NAION patients with comorbidities. In this large retrospective study, the authors studied whether patients with NAION were at risk of developing future strokes.

Study design

Investigators of this retrospective population-based cohort study mined records from a Korean health insurance database. They identified 400,952 eligible beneficiaries, of which 1,125 developed NAION and 16,998 suffered from a stroke.

Outcomes

NAION was not associated with an increased risk of subsequent stroke (HR 1.31). The findings were consistent even after adjusting for demographics and/or confounding factors.

Limitations

Although the study included a large number of patients, the database did not include information on possible confounding variables such as metabolic profiles, physical activity, body mass index, alcohol consumption or smoking. 

Clinical significance

This study found no associations between NAION and a subsequent risk of stroke in an Asian population. These results support the theory that different pathogenic mechanisms are responsible for the development of NAION and stroke.