Impact of Lipid Parameters on Visual Acuity Change in Non-Arteritic Anterior Ischemic Optic Neuropathy

Purpose: To assess the potential influence of serum biochemical factors, specifically lipid profile parameters, on visual outcomes in patients with non-arteritic anterior ischemic optic neuropathy (NAION). Patients and Methods: All patients diagnosed with NAION at Rajavithi Hospital between 1 January 2011 and 31 December 2020 were retrospectively reviewed. The primary outcome was defined as visual recovery, measured by an improvement of at least 0.2 logarithm of the minimal angle of resolution (logMAR) in their best-corrected visual acuity (BCVA) at the 12-weeks follow-up visit compared to the initial visit and determine whether those lipid profiles parameters are predictive of 12 weeks-visual outcomes. Factors of an initial poor VA were evaluated using logistic regression analysis. Results: In this study, 84 patients with NAION were included to assess the impact of lipid parameters on visual outcomes. Majority of participants were male. The group with initial VA worse than 20/200 had significantly higher mean age of 58.3 +/- 7.6 years and levels of total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL) (all p < 0.05 respectively). Throughout 12 weeks, a significant difference in change of BCVA between the two groups of initial VA was observed (p<0.001). Regarding lipid parameters on visual prognosis, lipid profile between the two groups of VA improvement of 0.2 logMAR was comparable different. The probability of VA improvement showed a weak association with TC levels. A gradual increase in probability slightly related to LDL parameter, while TG showed an inverse relationship. At elevated lipid levels, there was a greater degree of uncertainty in predicting visual outcomes. Conclusion: While older age and elevated lipid levels, specifically TC, TGs, and LDL, were correlated with poorer initial visual acuity in NAION patients, no significant associations were identified between lipid parameters and long-term visual recovery. Early detection for individuals with dyslipidemia (DLP) and advanced age merit attention.