Hyperhomocysteinemia: a risk factor for central retinal vein occlusion

• Published in: American journal of ophthalmology Vol. 129; no. 5; pp. 640 - 644
• Main Author: Vine, Andrew K
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2000
• Subjects: Adult; Aged; Aged, 80 and over; Case-Control Studies; Female; Homocysteine - blood; Humans; Hyperhomocysteinemia - blood; Hyperhomocysteinemia - complications; Male; Middle Aged; Odds Ratio; Prognosis; Retinal Vein Occlusion - blood; Retinal Vein Occlusion - etiology; Risk Factors
• ISSN: 0002-9394; 1879-1891
• DOI: 10.1016/S0002-9394(99)00476-6

PURPOSE: Previous studies have documented that elevated plasma homocysteine level is a risk factor for vascular disease. This study was performed to determine whether hyperhomocysteinemia is a risk factor for central retinal vein occlusion. METHODS: In a case-control study, data from 74 patients with documented central retinal vein occlusion were reassessed. Control subjects consisted of individuals referred to the same clinic for assessment of a nonretinal vascular disease. Hyperhomocysteinemia was defined as a total plasma homocysteine level above the 95th percentile in the control group. RESULTS: The mean total plasma homocysteine level was 11.58 ± 4.67 μmol/l (range, 5–26 μmol/l) for cases, and 9.49 ± 2.65 μmol/l (range, 5–20 μmol/l) for control subjects. Of the 74 patients with a central retinal vein occlusion, 16 (21.6%) had total plasma homocysteine levels above the 95th percentile in the control group (odds ratio, 6.53; 95% confidence interval, 1.81–23.50; P = .003). Hyperhomocysteinemia was present in five (55%) of the nine individuals with bilateral disease, nine (30%) of the 30 patients with ischemic occlusions, and 45 (31%) of the 83 eyes with severe visual loss. CONCLUSION: Hyperhomocysteinemia is a risk factor for central retinal vein occlusion and may suggest a poor prognosis in patients with central retinal vein occlusion.