@article {913416,
	title = {Demographic, Systemic, and Ocular Factors Associated with Nonarteritic Anterior Ischemic Optic Neuropathy.},
	journal = {Ophthalmology},
	volume = {123},
	number = {12},
	year = {2016},
	month = {2016 Dec},
	pages = {2446-2455},
	abstract = {OBJECTIVE: Nonarteritic anterior ischemic optic neuropathy (NAION) is a devastating ocular condition causing permanent vision loss. Little is known about risk factors for developing this disease. We assessed demographic, systemic, and ocular factors associated with NAION. DESIGN: Retrospective longitudinal cohort study. PARTICIPANTS: Beneficiaries between 40 and 75 years old without NAION at baseline enrolled in a large U.S. managed care network. METHODS: Enrollees were monitored continuously for >=2 years between 2001 and 2014 to identify those newly diagnosed with NAION (International Classification of Diseases, 9th Revision, Clinical Modification [ICD-9-CM] code 377.41). All persons were under ophthalmic surveillance and all cases had >=1 confirmatory ICD-9-CM code for NAION during follow-up. MAIN OUTCOME MEASURES: Multivariable Cox regression modeling was used to generate hazard ratios (HRs) with 95\% confidence intervals (CIs) to describe the statistical relationship between selected demographic characteristics, systemic and ocular conditions, and the hazard of developing NAION. RESULTS: Of 1 381 477 eligible enrollees, 977 (0.1\%) developed NAION during a mean {\textpm} standard deviation (SD) follow-up of 7.8{\textpm}3.1 years. The mean {\textpm} SD age for NAION cases at the index date was 64.0{\textpm}9.2 years vs. 58.4{\textpm}9.4 years for the remainder of the beneficiaries. After adjustment for confounding factors, each additional year older was associated with a 2\% increased hazard of NAION (HR\&nbsp;= 1.02; 95\% CI: 1.01-1.03). Female subjects had a 36\% decreased hazard of developing NAION (HR\&nbsp;= 0.64; 95\% CI: 0.55-0.74) compared with male subjects. Compared with whites, Latinos had a 46\% decreased hazard of developing NAION (HR\&nbsp;= 0.54; 95\% CI: 0.36-0.82), whereas African ancestry was not significantly associated with NAION (HR\&nbsp;= 0.91; 95\% CI: 0.72-1.15). Systemic diseases associated with NAION included hypertension (HR\&nbsp;= 1.62; 95\% CI: 1.26-2.07) and hypercoagulable states (HR\&nbsp;= 2.46; 95\% CI: 1.51-4.00). Although diabetes mellitus (DM) was not significantly associated with NAION compared with those without DM (P\&nbsp;= 0.45), patients with end-organ involvement from DM had a 27\% increased hazard of NAION relative to those with uncomplicated DM (HR\&nbsp;= 1.27; 95\% CI: 1.01-1.59). Ocular diseases associated with NAION were age-related macular degeneration (HR\&nbsp;= 1.29; 95\% CI: 1.08-1.54) and retinal vein occlusion (HR\&nbsp;= 3.94; 95\% CI: 3.11-4.99). CONCLUSIONS: Our study identified several modifiable risk factors that may be associated with NAION. Should future studies confirm these findings, they may offer opportunities to prevent or treat this debilitating condition.},
	issn = {1549-4713},
	doi = {10.1016/j.ophtha.2016.08.017},
	author = {Cestari, Dean M and Gaier, Eric D and Bouzika, Peggy and Blachley, Taylor S and De Lott, Lindsey B and Rizzo, Joseph F and Wiggs, Janey L and Kang, Jae H and Pasquale, Louis R and Stein, Joshua D}
}
