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Cardiometabolic factors and risk of non-arteritic anterior ischemic optic neuropathy: a systematic review and meta-analysis

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Abstract

Purpose

The purpose of this systematic review and meta-analysis of the literature is to evaluate the association between cardiometabolic risk factors (hypertension, diabetes mellitus, hypercholesterolemia/dyslipidemia, HDL cholesterol, LDL cholesterol, lipoprotein(a), and triglycerides) and non-arteritic anterior ischemic optic neuropathy (NAION).

Methods

Pertinent publications were identified through a systematic search in PubMed and EMBASE databases, without language restrictions. The pooled odds ratios (OR) and standardized mean differences (SMD), with their 95% confidence intervals (95% CI) were estimated using random effects (DerSimonian Laird) models, as appropriate. A set of subgroup analyses and meta-regression analysis models were performed.

Results

Twenty-one studies (including 1560 patients with NAION and 2292 controls), examining the association between NAION and cardiometabolic risk factors, were eligible for the systematic review and meta-analysis. Hypertension (pooled OR = 1.50; 95% CI: 1.16–1.94), diabetes mellitus (pooled OR = 1.71; 95% CI: 1.33–2.21), and hypercholesterolemia/dyslipidemia (pooled OR = 2.00; 95% CI: 1.53–2.62) were associated with NAION. Among the components of dyslipidemia, higher serum triglycerides were associated with NAION, with a medium effect size (SMD =  + 0.58, 95% CI: + 0.12 to + 1.04), whereas synthesis of four studies reporting on HDL and LDL cholesterol did not reveal any significant associations. A significant association between NAION and higher serum lipoprotein(a) levels (pooled OR = 2.88; 95%CI: 1.01–8.21) was also noted.

Conclusions

This systematic review and meta-analysis found that NAION was associated with cardiometabolic factors, suggesting that vascular dysfunction may be implicated in the pathogenesis of the disease. Our findings may alert health care providers to try modifying these risk factors for NAION prevention.

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Authors and Affiliations

  1. 2nd Department of Ophthalmology, National and Kapodistrian University of Athens, 1, Rimini Street, Haidari, 12462, Athens, Greece

    Irini P. Chatziralli, Dimitrios Kazantzis, Genovefa Machairoudia, George P. Theodossiadis & Panagiotis G. Theodossiadis

  2. 2nd Department of Ophthalmology, Ophthalmiatrion Athinon, Athens, Greece

    Alexandros P. Chatzirallis

  3. Department of Biomedical Sciences, University of West Attica, Athens, Greece

    Effie G. Papageorgiou & Theodoros N. Sergentanis

  4. Department of Clinical Therapeutics, Alexandra Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece

    Theodora Psaltopoulou & Theodoros N. Sergentanis

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  1. Irini P. Chatziralli
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  2. Dimitrios Kazantzis
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Contributions

I.C., D.K., and T.S. conceived and designed the meta-analysis; I.C., D.K., A.C., and G.M. performed the literature search and collected data; E.P., T.P., and T.S. performed the statistical analysis; I.C. and T.S. drafted the manuscript; I.C., G.T., E.P., T.P., P.T., and T.S. critically revised the manuscript. All authors have read and approved the current version of the manuscript.

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Correspondence to Irini P. Chatziralli.

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Chatziralli, I.P., Kazantzis, D., Chatzirallis, A.P. et al. Cardiometabolic factors and risk of non-arteritic anterior ischemic optic neuropathy: a systematic review and meta-analysis. Graefes Arch Clin Exp Ophthalmol 260, 1445–1456 (2022). https://doi.org/10.1007/s00417-021-05522-4

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