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Published on: August 6, 2021
Hyperhomocysteinemia: a new risk factor for central retinal vein occlusion
1University of Michigan Medical School, Department of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, Ann Arbor, Michigan, USA.
Insights
Elevated plasma homocysteine, a condition known as hyperhomocysteinemia, is a significant risk factor for central retinal vein occlusion. This finding highlights the importance of monitoring homocysteine levels for eye health.
Area of Science:
- Ophthalmology
- Vascular Medicine
- Clinical Research
Background:
- Elevated plasma homocysteine is a known risk factor for various vascular diseases.
- Central retinal vein occlusion (CRVO) is a serious vascular condition affecting the eye.
Purpose of the Study:
- To investigate whether hyperhomocysteinemia is a risk factor for central retinal vein occlusion.
- To determine the association between high homocysteine levels and CRVO incidence.
Main Methods:
- A case-controlled study was conducted with 74 patients diagnosed with CRVO.
- Control subjects were individuals assessed for non-retinal vascular diseases.
- Hyperhomocysteinemia was defined as total plasma homocysteine above the 95th percentile in controls.
Main Results:
- Patients with CRVO had a higher mean plasma homocysteine level (11.58 mumol/L) compared to controls (9.49 mumol/L).
- 21.6% of CRVO patients exhibited hyperhomocysteinemia (odds ratio, 6.53; P = .003).
- Hyperhomocysteinemia was more prevalent in cases with bilateral disease (55%), ischemic CRVO (30%), and severe vision loss (31%).
Conclusions:
- Hyperhomocysteinemia is confirmed as a significant risk factor for central retinal vein occlusion.
- These findings suggest a potential link between homocysteine levels and CRVO pathogenesis.
- Monitoring homocysteine may be beneficial in assessing CRVO risk.
Purpose:
Previous studies have documented that an elevated plasma homocysteine level is a risk factor for vascular disease. The purpose of this study is to determine whether hyperhomocysteinemia is a risk factor for central retinal vein occlusion.
Methods:
This case-controlled study involved reassessment of 74 patients with documented central retinal vein occlusion. 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 mumol/L for cases and 9.49 mumol/L for controls. Of the 74 patients with a central retinal vein occlusion, 21.6% had total plasma homocysteine levels above the 95th percentile in the control group (odds ratio, 6.53; 95% confidence interval, 1.81 to 23.50, P = .003). Hyperhomocysteinemia was present in 55% of cases with bilateral disease, 30% of ischemic cases, and 31% of cases with severe visual loss.
Conclusion:
Hyperhomocysteinemia is a risk factor for central retinal vein occlusion.
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