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Raised plasma homocysteine as a risk factor for retinal vascular occlusive disease
M Cahill1, M Karabatzaki, R Meleady
1The Research Foundation, The Royal Victoria Eye and Ear Hospital, Adelaide Road, Dublin 2, Ireland.
Insights
Elevated plasma homocysteine (tHcy) is a risk factor for retinal vascular occlusive disease. This study found higher tHcy levels in patients with retinal artery and central retinal vein occlusions, indicating tHcy is an independent risk factor.
Area of Science:
- Ophthalmology
- Cardiovascular Medicine
- Clinical Biochemistry
Background:
- Elevated plasma homocysteine (tHcy) is a known risk factor for atherosclerotic vascular disease.
- Retinal vascular occlusive disease shares risk factors with other atherosclerotic conditions.
- The association between elevated tHcy and retinal vascular occlusive disease remains unclear.
Purpose of the Study:
- To assess the relationship between retinal vascular occlusive disease and elevated plasma total homocysteine (tHcy) levels.
- To determine if tHcy is an independent risk factor for retinal vascular occlusive disease.
Main Methods:
- A retrospective case-control study was conducted.
- 87 cases of retinal vascular occlusive disease (retinal artery, central retinal vein, branch retinal vein occlusions) were compared with 87 age-matched controls.
- Plasma tHcy levels (≥ 12 micromol/l) were analyzed in relation to disease risk.
Main Results:
- Mean tHcy levels were significantly higher in patients with retinal artery occlusions (p=0.032) and central retinal vein occlusion (p=0.0001).
- Elevated tHcy was identified as an independent risk factor for retinal vascular occlusive disease (OR 2.85).
- The association remained significant after adjusting for known cardiovascular risk factors.
Conclusions:
- Elevated plasma tHcy is an independent risk factor for retinal vascular occlusive disease.
- Measuring tHcy may be crucial for investigating and managing patients with retinal vascular occlusive disease.
Background/Aims:
A moderately elevated plasma concentration of the sulphur amino acid homocysteine is an independent risk factor for atherosclerotic vascular disease. Many of the risk factors associated with coronary, cerebral, and peripheral atherosclerotic vascular disease are common to retinal vascular occlusive disease but it is unclear whether elevated plasma concentrations of homocysteine are also associated with such disease. This study assessed the relation between retinal vascular occlusive disease and elevated levels of plasma total homocysteine (tHcy).
Methods:
A retrospective case-control study involving hospital based controls and cases with retinal artery, central retinal vein (including hemiretinal vein), and branch retinal vein occlusions was performed. The relation between elevated tHcy, defined as a level greater than or equal to 12 micromol/l and risk of retinal vascular occlusive disease was examined.
Results:
87 cases of retinal vascular occlusive disease including 26 cases of retinal artery occlusion, 40 cases with central retinal vein occlusion, and 21 cases of branch retinal vein occlusion were compared with 87 age matched controls. Mean tHcy levels were higher in all disease groups and this difference was significant in patients with retinal artery occlusions (p= 0.032) and patients with central retinal vein occlusion (p=0.0001). When adjusted for known cardiovascular risk factors, tHcy was an independent risk factor for retinal vascular occlusive disease (OR 2.85 (95% CI 1.43-5.68)).
Conclusions:
Elevated tHcy is an independent risk factor for retinal vascular occlusive disease. Assessment of tHcy may be important in the investigation and management of patients with retinal vascular occlusive disease.