A secondary analysis of the QRK207 trial examined 729 participants with acute Nonarteritic Anterior Ischemic Optic Neuropathy. The researchers looked at how combinations of clinical and systemic risk factors affected visual function progression over a two-month period. They used structured trial variables to build models predicting who might experience vision loss. The study included only participants from the pre-treatment and placebo groups to ensure a clear comparison.
The models showed modest performance in predicting visual decline. Early vision loss was associated with fellow-eye NAION, obstructive sleep apnea, and higher diastolic pressure. Later progression reflected metabolic and vascular stress. Conversely, preserved retinal nerve fiber layer thickness, normal renal indices, and diabetes medication use were linked to lower risk.
The study has important limitations. No features were extracted from raw OCT scans, fundus photographs, or visual field images. Analyses were limited to structured clinical and systemic variables. Improved prediction will likely require richer ophthalmic biomarkers and multimodal models. This analysis supports future efforts to develop better biomarker-based and longitudinal modeling for this condition.