PURPOSE Prior studies have shown that non-arteritic anterior ischemic optic neuropathy (NAION) is uncommon in persons of Black race compared to those of White race, but the reasons behind this discrepancy remain unknown. Our goal was to analyze the systemic and ocular features of Black NAION patients compared to White patients. DESIGN Retrospective cross-sectional study METHODS: Self-reported race was collected from all NAION patients seen between 2014-2022 from a single US neuro-ophthalmology service. All Black NAION patients and a randomly selected sample of White NAION patients were included. We collected information on hypertension, hyperlipidemia, diabetes mellitus, hypothyroidism, obesity, ischemic heart disease, atrial fibrillation, pacemaker insertion, chronic kidney disease, dialysis, anemia, obstructive sleep apnea, deep vein thrombosis, stroke, use of phosphodiesterase inhibitors, and smoking status. We reviewed color fundus photographs and optic nerve OCT images to assess cup-to-disc ratio and document the presence of optic disc drusen. Counterfactual random forest was used to estimate associations for each characteristic of interest by race controlling for the other exposures. RESULTS We included 32 Black NAION patients (mean age 57 ± 11 years, 38% men) and 69 of 432 White patients (mean age 57 ± 15 years, 59% men). Time between NAION onset and neuro-ophthalmic examination was significantly longer in Black patients (1.5 to <3 months: OR 4.07, P = 0.03; 6 to <12 months: OR 6.05, P = 0.007). Chronic kidney disease (OR 7.53, P = 0.003) and hemodialysis (OR 13.69, P = 0.02) were significantly more frequent in Black patients. No significant differences in cup-to-disc ratio were present (0.15 to <0.25: OR 2.83, P = 0.09; 0.25 to <0.35: OR 0.56, P = 0.46; ≥0.35: OR 0.66, P = 0.44). CONCLUSION Referral delay occurs in Black patients with NAION, likely due to its relative rarity and concern for alternate diagnoses. Black NAION patients were substantially more likely to have chronic kidney disease and be on dialysis than White patients. Despite known racial differences in cup-to-disc ratio, we found no difference between Black and White NAION patients, suggesting that the underlying proposed compartment mechanism is the same between races.

中文翻译：

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黑人患者的非动脉炎性前缺血性视神经病变。


目的 先前的研究表明，与白人相比，非动脉炎性前缺血性视神经病变 （NAION） 在黑人中并不常见，但这种差异背后的原因仍然未知。我们的目标是分析黑人 NAION 患者与白人患者相比的全身和眼部特征。设计 回顾性横断面研究方法： 从 2014-2022 年间从一家美国神经眼科服务机构就诊的所有 NAION 患者收集自我报告的种族。包括所有黑人 NAION 患者和随机选择的白人 NAION 患者样本。我们收集了高血压、高脂血症、糖尿病、甲状腺功能减退症、肥胖、缺血性心脏病、心房颤动、起搏器插入、慢性肾病、透析、贫血、阻塞性睡眠呼吸暂停、深静脉血栓形成、中风、磷酸二酯酶抑制剂的使用和吸烟状况的信息。我们回顾了彩色眼底照片和视神经 OCT 图像，以评估杯盘比值并记录视盘玻璃膜疣的存在。反事实随机森林用于按种族控制其他暴露来估计每个感兴趣特征的关联。结果我们纳入了 32 名黑人 NAION 患者 （平均年龄 57 ± 11 岁，38% 为男性） 和 432 名白人患者中的 69 名 （平均年龄 57 ± 15 岁，59% 为男性）。黑人患者 NAION 发作和神经眼科检查之间的时间显著更长 （1.5 至 <3 个月：OR 4.07，P = 0.03;6 至 <12 个月：OR 6.05，P = 0.007）。黑人患者的慢性肾病 （OR 7.53，P = 0.003） 和血液透析 （OR 13.69，P = 0.02） 的发生率显著更高。杯盘比无显著差异 （0.15 至 <0.25： OR 2.83，P = 0.09;0.25 至 <0.35： OR 0.56，P = 0。46;≥0.35： OR 0.66， P = 0.44）。结论 NAION 黑人患者发生转诊延迟，可能是由于其相对罕见和对替代诊断的担忧。黑人 NAION 患者比白人患者更有可能患慢性肾病和接受透析。尽管已知的杯盘比存在种族差异，但我们发现黑人和白人 NAION 患者之间没有差异，这表明拟议的潜在隔室机制在种族之间是相同的。