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Optic neuritis (ON) is known to elevate the risk of systemic autoimmune disorders. However, it remains uncertain whether ON serves as a risk factor for CHF and AF. This study aimed to investigate the association between ON and the risk of CHF and AF in a nationwide, population-based cohort. The research utilized data from Korea's National Health Insurance Service, analyzing 15,587 patients newly diagnosed with ON and 77,935 age- and sex-matched controls from 2010 to 2017. Factors of demographics, medical history, lifestyle, and lab results were considered. CHF and AF incidences were identified through ICD-10 codes and analyzed using Cox regression models adjusted for confounders. During the 4-year follow-up, CHF and AF were diagnosed in 3.39 and 0.86% of participants, respectively. ON patients showed higher risks of CHF [hazard ratio (HR) = 1.341] and AF (HR = 1.215) after adjusting for potential confounders. Notably, stronger associations for CHF risk were found in patients younger than 50 years and those in the lowest income quartile. The findings provide compelling evidence of an independent association between ON and increased risks of CHF and AF, especially in younger individuals, suggesting a role of autoimmune processes in ON under these cardiovascular conditions. The study highlights the need for early cardiac evaluation in ON patients and suggests that timely interventions could improve prognosis. Further research is necessary to understand the pathophysiological links between ON and cardiovascular disorders.<\/jats:p>","DOI":"10.1093\/pnasnexus\/pgaf312","type":"journal-article","created":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T04:16:57Z","timestamp":1764562617000},"source":"Crossref","is-referenced-by-count":0,"title":["Optic neuritis and risk of heart failure and atrial fibrillation: A nationwide cohort study"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8003-5849","authenticated-orcid":false,"given":"Jaeryung","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul 06351 ,","place":["Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min-Su","family":"Kim","sequence":"additional","affiliation":[{"name":"Sungkyunkwan University School of Medicine , Seoul 06351 ,","place":["Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyungdo","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Statistics and Actuarial Science, Soongsil University , Seoul 07038 ,","place":["Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8920-8777","authenticated-orcid":false,"given":"Jin-hyung","family":"Jung","sequence":"additional","affiliation":[{"name":"Samsung Biomedical Research Institute, Sungkyunkwan University School of Medicine , Seoul 06351 ,","place":["Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7907-5635","authenticated-orcid":false,"given":"Kyung-Ah","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul 06351 ,","place":["Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sei Yeul","family":"Oh","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul 06351 ,","place":["Republic of Korea"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,12,1]]},"reference":[{"key":"2026020603414556200_pgaf312-B1","volume-title":"Congestive heart failure","author":"Malik","year":"2023"},{"key":"2026020603414556200_pgaf312-B2","doi-asserted-by":"crossref","first-page":"1563","DOI":"10.1161\/CIRCULATIONAHA.106.666818","article-title":"Prevalence and prognostic significance of heart failure stages: application of the American College of Cardiology\/American Heart Association heart failure staging criteria in the 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