Associations between thrombophilic risk factors and determinants of atherosclerosis and inflammation in patients with non-arteritic anterior ischaemic optic neuropathy

Summary

Non-arteritic anterior ischaemic optic neuropathy (NAION) is caused by ischaemia of the optic nerve head. The pathophysiology of NAION is unclear, and no proven effective treatment exists. Patients, methods: We analyzed thrombophilic risk factors and determinants of atherosclerosis and inflammation in 109 consecutive patients and 109 age- and sex-matched volunteers using a case-control design. Results: High levels of fibrinogen (>384 mg/dl; OR 3.2, p = 0.003), factors VIII:C (>183%; OR 2.6, p = 0.02), IX (>153%; OR 2.6, p = 0.026), XI (>142%; OR 3.4, p = 0.006), von Willebrand factor (activity >205%; OR 3.1, p = 0.005; antigen >194%; OR 3.5, p = 0.002), and triglycerides (>228 mg/dl; OR 2.8, p = 0.026), higher platelet counts (>294 000/[uni03BC]l; OR 2.5, p = 0.04), low levels of HDL cholesterol (<40 mg/dl; OR 2.7, p = 0.032), and an accelerated erythrocyte sedimentation rate (>20 mm/h; OR 4.4, p = 0.003) were associated with NAION. Conclusion: Our findings support the contention of a complex pathogenesis of NAION resulting from the coincidence of proatherogenic, prothrombotic and proinflammatory processes. The alterations described could be causative, side effects, or just coincidental findings.

Zusammenfassung

Die nichtarteriitische anteriore ischämische Optikusneuropathie (NAION) wird durch eine Ischämie des Sehnervenkopfs bedingt. Die Pathophysiologie der NAION ist nicht geklärt, und bisher gibt es keine Behandlung, die sich als effektiv erweisen konnte. Patienten, Methoden: Wir haben thrombophile Risikofaktoren und Determinanten der Atherosklerose und Inflammation bei 109 konsekutiven Patienten und 109 alters- und geschlechtsangepassten Freiwilligen in einem Fall-KontrollStudien-Design analysiert. Ergebnisse: Hohe Werte für Fibrinogen (>384 mg/dl; OR 3,2, p = 0,003), Faktor VIII:C (>183%; OR 2,6, p = 0,02), Faktor IX (>153%; OR 2,6, p = 0,026), Faktor XI (>142%; OR 3,4, p = 0,006), vonWillebrand-Faktor (Aktivität >205%; OR 3,1, p = 0,005; Antigen >194%; OR 3,5, p = 0,002) und Triglyzeride (>228 mg/dl; OR 2,8, p = 0,026), hohe Thrombozytenwerte (> 294 000/[uni03BC]l; OR 2,5, p = 0,04), niedrige Werte für HDL-Cholesterin (<40 mg/dl; OR 2,7, p = 0,032) sowie eine beschleunigte BSG (>20 mm/h; OR 4,4, p = 0,003) waren mit der NAION assoziiert. Schlussfolgerung: Unsere Ergebnisse bestätigen den Verdacht einer komplexen Pathogenese einer NAION, die aus der Interaktion proatherogener, prothrombotischer und proinflammatorischer Prozesse hervorgeht. Diese Veränderungen können kausal zur Entstehung von NAION beitragen, könnten jedoch auch Nebeneffekte der NAION oder zufälliger Natur sein.

Keywords

NAION - risk factors - thrombophilia - atherosclerosis - inflammation

Schlüsselwörter

NAION - Risikofaktoren - Thrombophilie - Athero -sklerose - Inflammation

^* share senior authorship

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