Background: 

Nonarteritic anterior ischemic optic neuropathy (NAION) is a common cause of acute optic neuropathy in adults and is associated with vascular risk factors. Owing to the overlapping risk factor profiles between NAION and cerebral stroke, previous studies have produced conflicting results with regard to NAION as an independent risk factor for stroke.

Methods: 

A retrospective chart review was conducted using the Rochester Epidemiology Project database to identify all cases of NAION occurring among Olmsted County, Minnesota residents from January 1, 1990, through December 31, 2016. Stroke events were characterized using clinical and radiologic data. Comparison was made to an age- and sex-matched control group with similar vascular risk factors.

Results: 

One-hundred four patients with NAION and 104 control subjects were analyzed. Median age at diagnosis was 65 years (range, 40–90 years). Thirteen patients (13%) with NAION and 10 controls (10%) had symptomatic strokes after the age of 40 years. Among patients with NAION, 6 (46%) suffered a stroke before the diagnosis of NAION, 5 (39%) at least 5 months after the NAION diagnosis, and 2 patients (15%) suffered strokes both before and after the NAION. The cumulative probability of symptomatic strokes for patients with NAION was not significantly different than for controls (hazard ratio = 1.50, 95% confidence interval: 0.66–3.42; P = 0.34). There were no cardioembolic strokes within 1 month of the NAION diagnosis. The mechanism of symptomatic strokes did not differ between the 2 groups.

Conclusions: 

NAION does not confer an increased risk of symptomatic stroke beyond the risk posed by age and existing vascular risk factors.

中文翻译：

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非动脉性前部缺血性视神经病变的卒中率，亚型和心血管危险因素：基于人群的研究

背景： 

非动脉性前部缺血性视神经病变（NAION）是成人急性视神经病变的常见原因，并且与血管危险因素有关。由于NAION和脑卒中之间存在重叠的危险因素，以前的研究就NAION作为中风的独立危险因素产生了矛盾的结果。

方法： 

使用罗切斯特流行病学项目数据库进行了回顾性图表审查，以鉴定从1990年1月1日至2016年12月31日在明尼苏达州奥尔姆斯特德县居民中发生的所有NAION病例。中风事件使用临床和放射学数据进行表征。比较年龄和性别匹配的具有相似血管危险因素的对照组。

结果： 

分析了104例NAION患者和104例对照对象。诊断时的中位年龄为65岁（范围40-90岁）。40岁后有13例NAION患者（13％）和10例对照（10％）有症状性中风。在NAION患者中，有6名（46％）在诊断为NAION之前中风，5名（39％）在NAION诊断后至少5个月，有2名患者（15％）在NAION之前和之后均发生了中风。NAION患者有症状中风的累积概率与对照组无显着差异（危险比= 1.50，95％置信区间：0.66-3.42；P = 0.34）。在NAION诊断后的1个月内没有心脏栓塞性中风。两组的症状性中风的机制没有差异。

结论： 

NAION不会使症状性中风的风险增加到超过年龄和现有血管风险因素所带来的风险。