Abstract

Aim: Non-arteritic anterior ischemic optic neuropathy (NAION) is one of the most common causes of sudden, painless vision loss in individuals over the age of 50 and represents the second most frequent optic neuropathy after glaucoma. Our aim was to retrospectively evaluate refractive errors in individuals diagnosed with unilateral and bilateral NAION and to compare these parameters with those of healthy individuals, thereby elucidating the association between hyperopia, and the disease.

Method: This retrospective study included 52 patients diagnosed with NAION at our neuro-ophthalmology department between January and December 2024. Spherical equivalent (SE) values obtained by autorefractometry were classified as emmetropic (−0.50 to +0.50 D), myopic (< −0.50 D), or hyperopic (≥ +0.50 D). Refractive error distributions and mean SE values were compared among three groups: bilateral NAION (12 patients, 24 eyes), unilateral AION (40 patients, 40 eyes), and healthy controls (40 individuals, 40 eyes).

Results: In the control group, refractive error distribution was 32.5% emmetropic, 22.5% myopic, and 45.0% hyperopic, while in the bilateral NAION group, 66.7% were hyperopic, 25.0% emmetropic, and 8.3% myopic; whereas in the unilateral NAION group, 45.0% were hyperopic, 27.5% emmetropic, and 27.5% myopic. Mean SE values were +1.12 ± 1.44 D (range, −1.12 to +4.00) for the bilateral NAION group, +0.18 ± 1.14 D (range, −2.12 to +3.00) for the unilateral NAION group, and +0.19 ± 0.99 D (range, −2.25 to +1.87) for controls. Differences among groups were statistically significant (p = 0.003). Post hoc analysis demonstrated significantly greater hyperopia in the bilateral NAION group compared with both the unilateral NAION and control groups. No significant difference was observed between the unilateral NAION and control groups.

Conclusion: Patients with bilateral NAION demonstrated significantly higher levels of hyperopia compared with those with unilateral NAION and healthy controls. These findings suggest that hyperopia may represent a potential risk marker for bilateral NAION. Careful follow-up of hyperopic patients with unilateral NAION may be warranted to enable early detection and management of contralateral-eye involvement.

Keywords: anterior ischemic optic neuropathy, hyperopia, refractive errors, spherical equivalent

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Copyright (c) 2026 The Author(s). This is an open access article distributed under the Creative Commons Attribution License (CC BY), which permits unrestricted use, distribution, and reproduction in any medium or format, provided the original work is properly cited.

How to Cite

1.
Tongal S, Uzar İ, Taşkapılı M. Hyperopia as a risk factor for bilateral non-arteritic anterior ischemic optic neuropathy: a comparative retrospective study. J Trends Med Invest. 2025;1(3):70-6. https://doi.org/10.64512/JTMI.2025.16

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