The relationship between the level of stromal cell-derived factor-1 and internal carotid artery stiffness index, and patients with non-arteritic anterior ischemic optic neuropathy complicated by macular edema
10.3760/cma.j.cn511434-20250507-00206
- VernacularTitle:基质细胞衍生因子-1水平和颈内动脉僵硬度指数与非动脉炎性前部缺血性视神经病变合并黄斑水肿的关系
- Author:
Yao WANG
1
;
Wei WANG
;
Yan JI
;
Yanxiu QI
Author Information
1. 佳木斯大学附属第二医院眼科，佳木斯 154002
- Publication Type:Journal Article
- Keywords:
Stromal cell-derived factor-1;
Internal carotid artery stiffness index;
Non-arteritic anterior ischemic optic neuropathy;
Macular edema
- From:
Chinese Journal of Ocular Fundus Diseases
2025;41(6):458-466
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the relationship between the level of stromal cell-derived factor-1 (SDF-1), internal carotid artery stiffness index, and non-arteritic anterior ischemic optic neuropathy (NAION) with macular edema (ME).Methods:A retrospective study. A total of 202 patients with NAION diagnosed by ophthalmic examination in Department of Ophthalmology, The Second Affiliated Hospital of Jiamusi University from January 2023 to January 2025 were included in the study. Based on the presence or absence of ME, the patients were divided into the NAION+ME group and the NAION group, with 94 and 108 cases respectively. A prediction model was constructed based on the influencing factors. To comprehensively evaluate the predictive value of SDF-1 level and carotid artery stiffness index for NAION with ME, a multidimensional analytical approach was employed. The diagnostic performance of individual and combined markers was assessed by constructing receiver operating characteristic (ROC) curves and calculating the area under the curve (AUC). Multivariate logistic regression analysis was performed to determine their independent predictive value. Stratified subgroup analyses were conducted to explore predictive differences across various populations. Cox proportional hazards regression models were established to evaluate long-term predictive value. Restricted cubic spline (RCS) analysis was applied to reveal potential nonlinear dose-response relationships. Mediation effect models were constructed to analyze the mediating role of carotid artery stiffness index in the association between SDF-1 level and NAION with ME.Results:In the NAION+ME group, systolic blood pressure ( t=6.066), body mass index ( t=2.804), disease duration ( t=2.552), intraocular pressure ( t=2.574), high-density lipoprotein ( t=2.729), fasting blood glucose ( t=2.022), glycosylated hemoglobin ( t=7.235), SDF-1 level ( t=14.319), and internal carotid artery stiffness index ( t=2.633) were higher than those in the NAION group, while diastolic blood pressure was lower ( P<0.05). ROC curve analysis showed that the AUC of SDF-1 level combined with internal carotid artery stiffness index in predicting the risk of adverse prognosis was 0.894 [95% confidence interval (CI) 0.803-0.945], with a sensitivity of 87.98% and a specificity of 95.69%. Logistic regression analysis demonstrated significant independent correlations between SDF-1 level ( OR=1.682, 95% CI 1.156-1.986), internal carotid artery stiffness index ( OR=1.826, 95% CI 1.369-2.648), and the risk of ME in NAION patients ( P<0.05). Subgroup analysis revealed that elevated SDF-1 level and internal carotid artery stiffness index were associated with a higher risk of NAION with ME ( Pfor trend<0.05). RCS analysis demonstrated a nonlinear dose-response relationship between the continuous changes in SDF-1 level and internal carotid artery stiffness index and the risk of NAION with ME ( P<0.05). Mediation effect model analysis showed that internal carotid artery stiffness index played a mediating role between SDF-1 level and the risk of NAION with ME. Conclusions:SDF-1 level and internal carotid artery stiffness index are independent risk factors for ME in NAION patients. The combined detection of these two indicators holds significant value in predicting disease progression.
