Risk factors of developing non-arteric ischemic optic neuropathy in patients with type 2 diabetes mellitus: a...

To determine the risk factors and time to non-arteric ischemic optic neuropathy (NAION) occurrence among Thai type 2 diabetes mellitus (T2DM) patients.

A retrospective review of 266 newly diagnosed T2DM cases at Rajavithi Hospital between 2007 and 2016 was conducted to determine time to occurrence of NAION and evaluate associated risk factors.

Hypertension and dyslipidemia were the most common pre-existing vascular diseases and there was a significant male predominance in the NAION group. The mean age of the NAION group was significantly higher than that of the group without NAION. A higher proportion of subjects in the NAION group had hypertension, dyslipidemia, high diastolic blood pressure, smokers, and had a small cup-to-disc ratio (CDR). Higher levels of triglycerides and low-density lipoprotein-cholesterol in the group with NAION. Fifty-five patients among 266 participants (20.68%) developed NAION during a mean follow-up time of 81.26±25.04mo. In a multivariable logistic regression analysis, dyslipidemia (OR=8.36, 95%CI, 3.447-20.273, P<0.001), high low density lipoprotein levels (OR=1.017, 95%CI, 1.004-1.029, P=0.009), and small CDR (OR=11.92, 95%CI, 4.477-31.741, P<0.001) were significant risk factors for NAION development. Smoking was the strongest predictive risk (OR=12.843, 95%CI, 3.959-41.659, P<0.001). Vascular complications of T2DM and aspirin were not associated with NAION.

T2DM patients with dyslipidemia or a small CDR should be carefully followed up as they are at increased risk of developing NAION.