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Trombophilic screening for nonarteritic anterior ischemic optic neuropathy

  • Clinical Investigation
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Background

Nonarteritic anterior ischemic optic neuropathy (NAION) is an ischemic infarction of the optic nerve head, frequently leading to sudden, mostly irreversible loss of vision. In this study blood thrombophilic factors, as well as cardiovascular risk factors were investigated for their relevance to this pathology. Trombophilic risk factors so far not evaluated were included in the study.

Patients and methods

37 NAION patients (4 with sequential second eye involvement) and 81 matched control subjects were examined. From blood, protein C, protein S, antithrombin, von Willebrand antigen levels (vWFAg), and factor V (Leiden) mutation, factor VIIIC level, plasminogen activity, lipoprotein (a) and fibrinogen levels, and presence of anticardiolipin antibodies were investigated. Possibly relevant pathologies [e.g. diabetes mellitus (DM), hypertension, and ischemic heart disease] were also registered.

Results

Elevated Lp(a) and vWFAg levels, DM, F V (Leiden), hypercholesterolemia, and hyperfibinogenemia proved to be significant risk factors associated with NAION. Forward stepwise logistic regression analysis revealed that high Lp(a), DM, and FV (Leiden) were the main predictive components, with odds ratios 16.88 (p=0.012), 5.78 (p=0.022) and 4.44 (p=0.033), respectively.

Conclusions

Based on our results it appears that thrombophilia is likely to contribute to the development of NAION besides vascular damage due to the presence of cardiovascular risk factors. Further data are needed, however, to justify the suggested use of secondary prophylaxis using anticoagulant/antiplatelet therapy.

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Acknowledgements

The study was supported by the Hungarian Ministry of Health (grant no. ETT 51/2000).

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Authors and Affiliations

  1. Department of Ophthalmology, University of Debrecen, Medical and Health Science Center, Nagyerdei krt. 98, 4012, Debrecen, Hungary

    Valeria Nagy, Zita Steiber, Lili Takacs & Andras Berta

  2. Department of Biophysics and Cell Biology, University of Debrecen, Medical and Health Science Center, Debrecen, Hungary

    Gyorgy Vereb

  3. Clinical Research Center, University of Debrecen, Medical and Health Science Center, Debrecen, Hungary

    Zsuzsanna Bereczky

  4. Division of Rare Diseases, University of Debrecen, Medical and Health Science Center, Debrecen, Hungary

    Gyorgy Pfliegler

Authors
  1. Valeria Nagy
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  2. Zita Steiber
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  3. Lili Takacs
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  4. Gyorgy Vereb
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  5. Andras Berta
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  6. Zsuzsanna Bereczky
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Corresponding author

Correspondence to Valeria Nagy.

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Nagy, V., Steiber, Z., Takacs, L. et al. Trombophilic screening for nonarteritic anterior ischemic optic neuropathy. Graefe's Arch Clin Exp Ophthalmo 244, 3–8 (2006). https://doi.org/10.1007/s00417-005-1154-5

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  • DOI: https://doi.org/10.1007/s00417-005-1154-5

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