Diagnostic efficacy of total homocysteine and C-reactive protein for ocular ischemic syndrome

To assess diagnostic efficacy of plasma total homocysteine (tHcy) and C-reactive protein (CRP) levels for ocular ischemic syndrome (OIS).

In all, 87 patients with retinal vein occlusion (RVO), 955 patients with a stenosis of internal carotid artery (ICA) <90% and 159 patients with a stenosis of ICA >90% were included between 2003 and 2009. A total of 43 patients with a stenosis ICA >90% were diagnosed as OIS. Fasting tHcy, CRP, lipid profiles, creatinine were measured, and diagnostic values of hyperhomocysteinemia or elevated CRP for OIS were evaluated.

The mean plasma levels of tHcy (18.8 μmol/l) and CRP (1.1 mmol/l) were the highest in patients with OIS among the groups. The prevalences of hyperhomocysteinemia (72%) and elevated CRP (77%) were the highest in OIS among the groups. In patients with stenosis of ICA, the diagnostic sensitivity/specificity for OIS was 70/79% in hyperhomocysteinemia and 73/73% in elevated CRP. The diagnostic sensitivity and specificity for OIS were 53 and 86% in both hyperhomocysteinemia and elevated CRP. The lipid profiles and creatinine levels were similar among the groups.

Our results suggest that hyperhomocysteinemia and elevated CRP may be associated with the development of OIS. The measurements of tHcy and CRP in blood may help to assist the diagnosis of OIS in a stenosis of ICA.