Hyperhomocysteinemia: A risk factor for central retinal vein occlusion

PURPOSE: Previous studies have documented that elevated:plasma homocysteine level is a risk factor for vascular disease, This study was performed to determine whether hyperhomocysteinemia is a risk factor for central retinal vein occlusion, METHODS: In a case-control study, data from 74 patients:with documented central retinal vein occlusion were reassessed. 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 +/- 4,67 mu mol/l (range, 5-26 mu mol/l) for cases, and 9,49 +/- 2.65 mu mol/l (range, 5-20 mu mol/l) for control subjects. Of the 74 patients with a central retinal vein occlusion, 16 (21.6%) had total plasma homocysteine levels above the 95th percentile in the control group (odds ratio, 6.53; 95% confidence interval, 1.81-23.50; P = .003), Hyperhomocysteinemia was present in five (55%) of the nine individuals with bilateral disease, nine (30%) of the 30 patients with ischemic occlusions, and 45 (31%) of the 83 eyes with severe visual loss. CONCLUSION: Hyperhomocysteinemia is a risk factor for central retinal vein occlusion and may suggest a poor prognosis in patients with central retinal vein occlusion, (C) 2000 by Elsevier Science Inc, All rights reserved.