Document Detail


Incidence of nonarteritic anterior ischemic optic neuropathy: increased risk among diabetic patients.
MedLine Citation:
PMID:  21439645     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Previous studies have identified a higher prevalence of diabetes mellitus (DM) among patient cohorts with nonarteritic anterior ischemic optic neuropathy (NAION). We sought to determine the development of incident NAION among a group of newly diagnosed patients with DM and to estimate the incidence of NAION among the elderly.
DESIGN: Medicare 5% database study.
PARTICIPANTS: A total of 25 515 patients with DM and an equal number of age- and gender-matched nondiabetic patients.
METHODS: Query of Medicare 5% claims files identified patients with a new diagnosis of DM in 1994. A randomly selected control group was created using 1-to-1 propensity score matching. Patients with a diagnosis of giant cell arteritis, preexisting DM, and age 68 years or older or >95 years were excluded. Patients with DM and controls were followed for the development of NAION over the following 4745 days.
MAIN OUTCOME MEASURES: Incidence of NAION among patients with and without DM.
RESULTS: In each group, 85% were white, 11% were black, and 4% were other race. Patients were aged 76.4 years, and 40% were male. Mean follow-up was 7.6 years. In the diabetes group, 188 individuals developed NAION (0.7%) compared with 131 individuals (0.5%; P < 0.01) in the control group. In unadjusted Cox regression analysis, having DM was associated with a 43% increased risk (hazard ratio [HR]: 1.431; 95% confidence interval [CI], 1.145-1.789) of developing NAION. After adjusting for other covariates, the risk of developing NAION among individuals with DM was reduced to 40% (HR 1.397; 95% CI, 1.115-1.750). Male gender increased an individual's risk of developing NAION by 32% (HR 1.319; 95% CI, 1.052-1.654). No other covariate was statistically significantly associated with developing NAION. The annual incidence of NAION was 82 per 100 000 persons.
CONCLUSIONS: Diabetes mellitus significantly increased the risk of the diagnosis NAION. The incidence of NAION among patients aged more than 67 years may be higher than previously reported.
Authors:
Michael S Lee; Daniel Grossman; Anthony C Arnold; Frank A Sloan
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-03-24
Journal Detail:
Title:  Ophthalmology     Volume:  118     ISSN:  1549-4713     ISO Abbreviation:  Ophthalmology     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-04     Completed Date:  2011-07-08     Revised Date:  2014-09-22    
Medline Journal Info:
Nlm Unique ID:  7802443     Medline TA:  Ophthalmology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  959-63     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Age Distribution
Aged
Aged, 80 and over
Arteritis / epidemiology
Databases, Factual
Diabetes Mellitus / epidemiology*
Female
Follow-Up Studies
Humans
Incidence
Male
Medicare / statistics & numerical data
Optic Neuropathy, Ischemic / epidemiology*
Risk Factors
Sex Distribution
United States
Grant Support
ID/Acronym/Agency:
2R37-AG-17473-05A1/AG/NIA NIH HHS; R01 AG017473/AG/NIA NIH HHS; R37 AG017473/AG/NIA NIH HHS; R37 AG017473-05A1/AG/NIA NIH HHS
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