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[Peripheral retinal arterial obstruction associated with hyperhomocysteinemia: case report]
Alexandre Kazuo Misawa1, Hisashi Suzuki, Otacílio de Oliveira Maia
1Departamento de Oftalmologia, Faculdade de Medicina, Hospital das Clínicas, Universidade de São Paulo, São Paulo, Brasil.
Arquivos Brasileiros De Oftalmologia
|November 29, 2008
Summary
Hyperhomocysteinemia, a condition linked to vitamin deficiencies, can cause retinal vascular occlusion. Measuring and treating homocysteine levels with vitamins can successfully manage this condition.
Area of Science:
- Ophthalmology
- Vascular Medicine
- Nutritional Science
Background:
- Hyperhomocysteinemia is an established risk factor for thromboembolic events.
- Retinal vascular occlusive events can manifest in various forms, including arterial or venous occlusion.
Observation:
- A case of peripheral arteriolar network occlusion without vasculitis was observed.
- The patient presented with neovascularization, vitreous-retinal traction, and recurrent vitreous hemorrhage.
- Laboratory findings revealed vitamin B12 and folic acid deficiency leading to elevated homocysteine levels, without other coagulation abnormalities.
Findings:
- Elevated serum homocysteine levels, resulting from vitamin deficiencies, were identified as the direct cause of the retinal vascular occlusion.
- The condition was successfully managed with photocoagulation and vitamin supplementation.
Implications:
- Measuring total plasma homocysteine levels is crucial for patients with retinal vascular obstruction.
- Hyperhomocysteinemia is a modifiable risk factor for retinal vascular events and can be treated with vitamin supplementation.
- Early diagnosis and management of hyperhomocysteinemia can prevent severe ocular complications.
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