Journal of Hebei Medical University ›› 2025, Vol. 46 ›› Issue (7): 818-825.doi: 10.3969/j.issn.1007-3205.2025.07.012

Previous Articles     Next Articles

Establishment of a clinical prediction model for the onset of contralateral eye in non-arteritic anterior ischemic optic neuropathy

  

  1. 1.Department of Ophthalmology, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, 
    China; 2.Department of Ophthalmology, Hebei Eye Hospital, Xingtai 054001, China; 3.Department of 
    Translational Science, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, 
    China; 4.Department of Academic Affairs, the Second Hospital of 
    Hebei Medical University, Shijiazhuang 050000,China

  • Online:2025-07-25 Published:2025-07-24

PDF (PC)

41

Abstract: Objective To explore the risk factors for the onset of contralateral eye in non-arteritic anteritic anterior ischemic optic neuropathy (NAION), and to construct clinical prediction models for evaluation. 
Methods A total of 151 patients with NAION who were hospitalized in the Eye Center of the Second Hospital of Hebei Medical University from October 2018 to December 2021 were included in the study.The follow-up period was ended until December 2022 to obtain their clinical data and calculate the NAION incidence of the contralateral eye. The Least absolute shrinkage and selection operator (LASSO) regression analysis method and K-fold (10-fold in this study) Cross-validation were used to screen the predictive factors, and Multivariate logistic regression analysis was used to construct a prediction model. The receiver operating characteristic (ROC) curve, Hosmer-Lemeshow test, decision curve analysis (DCA) were used to evaluate the prediction model and its clinical practicability. 
Results Nine predictive factors were identified from 23 variables, namely age, visual acuity at admission (V1), acute ischemic stroke (AIS), diabetes mellitus (DM), fasting blood-glucose (FBG), high blood pressure (HBP), total cholesterol (TC), optic disc drusen (ODD) in the contralateral eye, and cup/disc ratio (C/D) by the LASSO regression analysis. The prediction model constructed with the 9 predictors showed good predictive ability, with area under the ROC of 0.85, using Hosmer-Lemeshow test (P=0.239). In the DCA, when the risk threshold of patients in the model ranged from 5% to 94%, patients could benefit from this model, indicating that the model had high clinical application value. 
Conclusion DM, HBP, TC, ODD, small C/D are independent risk factors for the onset of contralateral eye of NAION patients. Age, V1, AIS, and FBG levels are closely associated with the onset of contralateral eye of NAION patients. Thus, the prediction model based on this has good predictive efficacy. 


Key words: optic neuropathy, ischemic, risk factors, clinical prediction model