Nonarteritic anterior ischemic optic neuropathy and the incidence of depression: a nationwide population-based study (2010–2017)

Background/Objectives: The risk of depression in patients with non-arteritic anterior ischemic optic neuropathy (NAION) has yet to be thoroughly researched. This study aimed to investigate the association between NAION and the onset of depression using a large-scale nationwide cohort in South Korea. Methods: This is a retrospective, nationwide cohort study involving 145,020 subjects without NAION and 29,004 individuals with a previous NAION diagnosis. Follow-up clinical data were collected until December 31, 2017. Multivariable adjustment models were employed to account for potential confounding factors. Results: The incidence of new-onset depression was significantly higher among NAION patients (incidence, 38.09 per 1000 person-years) than among non-NAION individuals (incidence, 29.91 per 1000 person-years). After adjusting for demographic factors, socioeconomic status, and comorbid diseases, the association remained significant (aHR = 1.271; 95% CI = 1.226–1.317). Notably, a subgroup analysis highlighted a particularly pronounced risk of depression in NAION patients aged 40 to 64 compared to those aged 65 or older (aHR = 1.34 vs. 1.207; interaction P = 0.0038). Conclusion: Our findings demonstrate a significant association between NAION and an increased risk of depression, especially in relatively younger patients aged 40 to 64 years. These results highlight the importance of regular monitoring and early intervention for depressive symptoms in patients with NAION.