Objective:

To explore the potential of lipid-derived indices as systemic biomarkers associated with nonarteritic anterior ischemic optic neuropathy (NAION).

Key Findings:

• Traditional lipid parameters were largely normal in both groups, but triglycerides were higher and HDL-C lower in the NAION group.
• Both the atherogenic index of plasma (AIP) and triglyceride–glucose (TyG) index were significantly elevated in NAION patients compared to controls.
• TyG remained significantly higher even after adjusting for fasting blood sugar.
• Neither AIP nor TyG correlated with functional or structural severity measures of NAION.

Interpretation:

The findings suggest that systemic metabolic vulnerability may be measurable in NAION patients, indicating a background metabolic milieu that predisposes to ischemic events rather than reflecting acute injury severity.

Limitations:

• The study is retrospective, single-center, and relatively small.
• Exclusion of patients with known hyperlipidemia may limit generalizability.

Conclusion:

NAION may be as much a systemic metabolic disease as a local optic nerve event, warranting further prospective studies to assess the predictive value of these indices.