Relationship between homocysteine levels, anterior chamber depth, and pseudoexfoliation glaucoma in patients with pseudoexfoliation

Purpose This study investigates the relationship between plasma homocysteine levels, anterior chamber depth (ACD), and pseudoexfoliation glaucoma (PEXG) in patients with pseudoexfoliation syndrome. Methods Sixty patients (F:M = 35:25) with pseudoexfoliation (PEX) were divided into two groups based on their plasma homocysteine levels; group 1 (< 20 mu mol/L, normal) and group 2 (>= 20 mu mol/L, high). Intraocular pressure (IOP) and ACD values as well as plasma homocysteine levels were compared between the two groups. Moreover, the mean values for ACD and IOP were compared between patients stratified according to the reference upper limit for the homocysteine level (above and below 14 mu mol/L), and the prevalence of high IOP was estimated. Results Groups 1 and 2 showed no statistically significant differences in the mean ACD (3.04 +/- 0.28 vs. 3.07 +/- 0.31 mm, respectively) and mean IOP (20.63 +/- 10.22 vs. 21.67 +/- 7.55 mmHg, respectively). Patients with PEX and homocysteine levels > 14 mu mol/L had a significantly increased prevalence (P < 0.05) of high IOP (>= 22 mmHg). Conclusions Patients with PEX and high homocysteine levels have an increased prevalence of high IOP. No relationship exists between plasma homocysteine levels and ACD. Thus, PEXG should be suspected in patients with PEX and high plasma homocysteine levels. Plasma homocysteine levels could be helpful for the diagnosis of PEXG, although larger sample studies are required to confirm this finding.