Elsevier

Ophthalmology

Volume 109, Issue 4, April 2002, Pages 749-752
Ophthalmology

Chlamydia pneumoniae seropositivity and the risk of nonarteritic ischemic optic neuropathy

https://doi.org/10.1016/S0161-6420(01)01031-4Get rights and content

Abstract

Objective

To determine whether IgG antibodies to Chlamydia pneumoniae are associated with nonarteritic ischemic optic neuropathy (NAION).

Design

Retrospective case-control study.

Participants

The study cohort consisted of 71 consecutive patients with NAION and 71 controls matched for age and gender.

Main outcome measures

Serum immunoglobulin G (IgG) antibody titers to Chlamydia pneumoniae.

Results

Patients with NAION had significantly higher IgG antibody titers to C. pneumoniae compared with control subjects (IgG titer ≥1:128: 29 patients versus 15 controls, P = 0.017). The odds ratio for patients with an IgG titer ≥1:128 was 2.56 (95% confidence interval [CI], 1.2–5.5). Adjustment for arterial hypertension, diabetes mellitus, and myocardial infarction resulted in an odds ratio of 3.48 (95% CI, 1.3–9.6).

Conclusions

Our results suggest that elevated titers of IgG antibodies to C. pneumoniae are associated with NAION.

Section snippets

Materials and methods

We studied 71 consecutive patients with NAION who met the inclusion criteria, and 71 controls matched for age and gender. All participants were seen at our department between January 1996 and June 2000 and gave written informed consent before enrollment. The study was approved by the Ethics Committee of the Karl-Franzens University, Graz, Austria.

Criteria for diagnosis of NAION included sudden visual loss, optic disc edema followed by optic atrophy, relative afferent pupillary defect, and

Results

We studied 71 patients (30 females and 41 males) with NAION and 71 age- and gender-matched control subjects. The mean age of patients was 68.1 ± 8.7 years (range, 48–83 years) and 68.3 ± 9.4 years (range, 47–84 years) for controls, respectively. The mean interval between occurrence of NAION and blood sampling for C. pneumoniae analysis was 15.8 months (range, 0–37 months). Within a mean follow-up time of 24.8 months (range, 9–46 months) bilateral NAION was diagnosed in 15 of 71 patients (21.1%).

Discussion

The main finding of our study is that seropositivity for IgG antibodies to C. pneumoniae was significantly more common in patients with NAION than in controls. Subjects with IgG titers ≥1:128 had an approximately twofold risk for NAION. The presence of IgG titers ≥1:256 increased the risk further to fourfold, thus suggesting an association between serologic evidence of C. pneumoniae infection and NAION.

Previous studies have shown that NAION affects both eyes in up to 40% of patients within 5 to

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    Copyright © 2002 American Academy of Ophthalmology, Inc. Published by Elsevier Inc. All rights reserved.