Supplementary Material for: Risk Factors for Fellow Eye Involvement in Patients with Nonarteritic Anterior Ischemic Optic Neuropathy

Introduction: The aim of the study was to investigate the possible risk factors for fellow eye involvement in patients with nonarteritic anterior ischemic optic neuropathy (NAION). Methods: A total of 113 patients with unilateral NAION attack were included and divided into two groups according to whether fellow eye involvement was present over a mean follow-up period of 2.70 years (P25–P75: 0.77–3.54 years). General characteristics (including age, sex, diabetes, hypertension, hyperlipidemia, and obstructive sleep apnea syndrome [OSAS]) and ocular characteristics (including initial best-corrected visual acuity, initial visual field damage of the first eye, and the presence/absence of a crowded disc) were analyzed and compared between the two groups. Cox regression was used to assess the risk factors for fellow eye involvement. Results: During the follow-up period, 40 patients developed fellow eye involvement. The initial best-corrected visual acuity (p = 0.048) and mean deviation of the visual field (VF) (p = 0.039) of the first eye in patients with fellow eye involvement were worse than those in patients without it. Diabetes (HR = 3.06, 95% CI: 1.50, 6.26, p = 0.002) and increased VF damage (moderate vs. mild, HR = 2.92, 95% CI: 1.03, 8.25, p = 0.043; severe vs. mild, HR = 5.01, 95% CI: 1.65, 15.20, p = 0.004) were associated with a significantly increased risk of fellow eye involvement. In 57 patients with apnea-hypopnea index (AHI) data for further study, an AHI score ≥23.2 was also found to be a risk factor (HR = 3.36, 95% CI: 1.17, 9.69, p = 0.025). Conclusion: Diabetes, severer initial VF damage, and more severe OSAS were risk factors for fellow eye involvement in NAION. For patients with these risk factors, more intensive follow-ups might be warranted.

引言：本研究旨在探讨非动脉炎性前部缺血性视神经病变（nonarteritic anterior ischemic optic neuropathy, NAION）患者对侧眼受累的潜在危险因素。方法：本研究共纳入113例单侧NAION发作患者，按平均随访2.70年（四分位间距P25–P75：0.77–3.54年）期间是否出现对侧眼受累分为两组。对两组患者的一般特征（包括年龄、性别、糖尿病、高血压、高脂血症及阻塞性睡眠呼吸暂停综合征（obstructive sleep apnea syndrome, OSAS））与眼部特征（包括初始最佳矫正视力、首患眼初始视野（visual field, VF）损害程度及视盘是否拥挤）进行分析比较。采用Cox回归模型评估对侧眼受累的危险因素。结果：随访期间，共有40例患者出现对侧眼受累。出现对侧眼受累的患者，其首患眼的初始最佳矫正视力（p=0.048）与视野平均缺损（p=0.039）均差于未受累患者。糖尿病（风险比HR=3.06，95%置信区间CI：1.50–6.26，p=0.002）及更严重的视野损害（中度vs轻度：HR=2.92，95%CI：1.03–8.25，p=0.043；重度vs轻度：HR=5.01，95%CI：1.65–15.20，p=0.004）与对侧眼受累风险显著升高相关。在57例具备呼吸暂停低通气指数（apnea-hypopnea index, AHI）数据的患者中进一步分析显示，AHI≥23.2同样为危险因素（HR=3.36，95%CI：1.17–9.69，p=0.025）。结论：糖尿病、初始视野损害程度更严重以及阻塞性睡眠呼吸暂停综合征病情更重均为NAION患者对侧眼受累的危险因素。对于存在上述危险因素的患者，应考虑给予更密切的随访。