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

SummaryNon-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.

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Fibrinogen, cholesterol and smoking as risk factors for non-arteritic anterior ischaemic optic neuropathy

Eye ◽

10.1038/eye.1995.13 ◽

1995 ◽

Vol 9 (1) ◽

pp. 85-88 ◽

Cited By ~ 37

Author(s):

S J Talks ◽

N H V Chong ◽

J M Gibson ◽

P M Dodson

Keyword(s):

Risk Factors ◽

Optic Neuropathy ◽

Ischaemic Optic Neuropathy ◽

Anterior Ischaemic Optic Neuropathy

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Non-arteritic anterior ischaemic optic neuropathy sequential to SARS-CoV-2 virus pneumonia: preventable by endothelial protection?

BMJ Case Reports ◽

10.1136/bcr-2020-240542 ◽

2021 ◽

Vol 14 (7) ◽

pp. e240542

Author(s):

Laura Moschetta ◽

Giuseppe Fasolino ◽

Robert W Kuijpers

Keyword(s):

Risk Factors ◽

Optic Nerve ◽

Optic Neuropathy ◽

Optic Nerve Head ◽

Systemic Risk ◽

Virus Pneumonia ◽

Ischaemic Optic Neuropathy ◽

Optic Nerve Head Circulation ◽

Anterior Ischaemic Optic Neuropathy ◽

Systemic Risk Factors

We present a case of non-arteritic anterior ischaemic optic neuropathy (NAION) with no ocular or systemic risk factors in a patient who recovered from a recent SARS-CoV-2 pneumonia. NAION is the most common acute optic neuropathy among individuals over 50 years of age. It results from a transient hypoperfusion of the optic nerve head circulation, especially in patients with low vascular compliance due to ocular or systemic risk factors. We attribute the ophthalmological condition to a SARS-CoV-2 virus-associated endotheliopathy that can be prevented with timely protection of endothelial function with vitamins D and K2.

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Risk Factors for Non-arteritic Anterior Ischaemic Optic Neuropathy in a Korean Population

Neuro-Ophthalmology ◽

10.1080/01658107.2016.1267771 ◽

2017 ◽

Vol 41 (2) ◽

pp. 68-75 ◽

Cited By ~ 3

Author(s):

Dae Hyun Kim ◽

Gwang Rae Shin ◽

Young Je Choi

Keyword(s):

Risk Factors ◽

Optic Neuropathy ◽

Korean Population ◽

Ischaemic Optic Neuropathy ◽

Anterior Ischaemic Optic Neuropathy

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Non-Arteritic Anterior Ischaemic Optic Neuropathy: Treatment and Risk Factors

Czech and Slovak Ophthalmology ◽

10.31348/2020/15 ◽

2020 ◽

Vol 76 (2) ◽

pp. 78-87

Author(s):

Silvie Kalábová ◽

Klára Marešová ◽

Marta Karhanová

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Visual Acuity ◽

Risk Factor ◽

Optic Neuropathy ◽

Systemic Risk ◽

Systemic Disease ◽

Department Of Ophthalmology ◽

Ischaemic Optic Neuropathy ◽

Anterior Ischaemic Optic Neuropathy

Aim: To ascertain whether various therapeutic procedures in non-arteritic anterior ischaemic optic neuropathy (NAION) have an impact on the resulting visual acuity of the affected eye. To assess the prevalence of risk factors that accompany this disease according to the literature. Methods: The retrospective study enrolled 55 eyes of 53 patients (41 men, 12 women) with an age range of 46 to 85 years (mean 64.9; median 64.0) who were hospitalized at the Department of Ophthalmology of the Faculty of Medicine and Dentistry and the University Hospital in Olomouc with the diagnosis of NAION between 2005 and 2016, and who received systemic treatment with intravenous vasodilators, either alone or in combination with intravenous corticosteroids. Central visual acuity (CVA) prior to treatment and immediately after its termination was evaluated. CVA was measured using the Snellen chart and is presented in decimal values. Using medical history data and medical records, the presence of systemic disease, namely hypertension, type 2 diabetes mellitus, and hypercholesterolaemia, was studied in these patients and evaluated for a possible association with NAION. Results: In the group of patients who were treated with intravenous vasodilators, the resulting CVA improved by 0.083 on average. In the group of patients who, in addition to vasodilator therapy, also received treatment with corticosteroids, the resulting CVA improved by only 0.03 on average. Although there was a more prominent improvement in CVA in the group treated with intravenous vasodilators alone, this difference was not statistically significant. At least one risk factor was found in the vast majority of the patients (96%). Eighty percent of the patients had hypertension, 43.6% of them were treated for diabetes mellitus, and 72.7% of the patients took drugs for hypercholesterolaemia. A combination of all these conditions was found in 36.4% of the patients. The proportion of smokers and past smokers did not exceed that of non-smokers. Conclusion: The mean improvement in the resulting CVA in patients after systemic therapy with vasodilators alone was greater than in those treated with a combination of vasodilators and corticosteroids; however, this difference was not statistically significant. In most patients in the group, at least one systemic risk factor was noted, most frequently hypertension. The prevalence rate of systemic risk factors was comparable to that reported in the literature.

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The Effect of n-3 Fatty Acids on Lipids and Haemostasis in Patients with Type lla and Type IV Hyperlipidaemia

Thrombosis and Haemostasis ◽

10.1055/s-0038-1646906 ◽

1989 ◽

Vol 62 (02) ◽

pp. 797-801 ◽

Cited By ~ 24

Author(s):

E Berg Schmidt ◽

E Ernst ◽

K Varming ◽

J O Pedersen ◽

J Dyerberg

Keyword(s):

Fatty Acids ◽

Plasma Lipids ◽

Plasma Cholesterol ◽

Hdl Cholesterol ◽

Apolipoprotein A1 ◽

Type Iv ◽

Before And After ◽

Von Willebrand ◽

Willebrand Factor ◽

Factor Antigen

SummaryPlasma lipids and haemostasis were investigated in 17 patients with hyperlipidaemia before and after 6 weeks supplementation with 6 g n-3 fatty acids. Nine of the patients had type IIa and 8 had type IV hyperlipidaemia. No effect on plasma cholesterol, LDL- or HDL-cholesterol were seen, but plasma triglycerides decreased after n-3 supplementation. Apolipoprotein B increased and apolipoprotein A1 decreased after the oil supplement. The bleeding time was prolonged, but platelet aggregation was unaltered by n-3 fatty acids. Protein C activity increased in type II a and decreased in type IV after the supplement. Fibrinolysis was markedly depressed while von Willebrand factor antigen was reduced after intake of n-3 fatty acids.

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The Genetic Defect of Type I von Willebrand Disease “Vicenza” Is Linked to the von Willebrand Factor Gene

Thrombosis and Haemostasis ◽

10.1055/s-0038-1651575 ◽

1993 ◽

Vol 69 (02) ◽

pp. 173-176 ◽

Cited By ~ 5

Author(s):

Anna M Randi ◽

Elisabetta Sacchi ◽

Gian Carlo Castaman ◽

Francesco Rodeghiero ◽

Pier Mannuccio Mannucci

Keyword(s):

Von Willebrand Factor ◽

Autosomal Dominant ◽

Genetic Defect ◽

Von Willebrand Disease ◽

Type I ◽

Bleeding Tendency ◽

Factor Gene ◽

Low Levels ◽

Von Willebrand ◽

Willebrand Factor

SummaryType I von Willebrand disease (vWD) Vicenza is a rare variant with autosomal dominant transmission, characterized by the presence of supranormal von Willebrand factor (vWF) multimers in plasma, similar to those normally found in endothelial cells and megakaryocytes. The patients have very low levels of plasma vWF contrasting with a mild bleeding tendency. The pathophysiology of this subtype is still unknown. The presence of supranormal multimers in the patients’ plasma could be due to a mutation in the vWF molecule which affects post-translational processing, or to a defect in the cells’ processing machinery, independent of the vWF molecule. In order to determne if type I vWD Vicenza is linked to the vWF gene, we studied six polymorphic systems identified within the vWF gene in two apparently unrelated families with type I vWD Vicenza. The results of this study indicate a linkage between vWF gene and the type I vWD Vicenza trait. This strongly suggests that type I vWD Vicenza is due to a mutation in one of the vWF alleles, which results in an abnormal vWF molecule that is processed to a lesser extent than normal vWF.

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