April 2009
Volume 50, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2009
The Associations Between Retinal Vascular Caliber and Homocysteine, Folate and Vitamin B12 Levels
B. Gopinath; J. J. Wang; G. Burlutsky; V. M. Flood; T. Y. Wong; P. Mitchell; Blue Mountains Eye Study
Author Affiliations & Notes
  • B. Gopinath
    Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute,
    University of Sydney, Sydney, Australia
  • J. J. Wang
    Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute,
    University of Sydney, Sydney, Australia
    Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
  • G. Burlutsky
    Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute,
    University of Sydney, Sydney, Australia
  • V. M. Flood
    Institute of Obesity, Nutrition and Exercise,
    University of Sydney, Sydney, Australia
  • T. Y. Wong
    Centre for Eye Research Australia, University of Melbourne, Melbourne, Australia
    Singapore Eye Research Institute, National University of Singapore, Singapore, Singapore
  • P. Mitchell
    Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute,
    University of Sydney, Sydney, Australia
  • Blue Mountains Eye Study
    University of Sydney, Sydney, Australia
  • Footnotes
    Commercial Relationships  B. Gopinath, None; J.J. Wang, None; G. Burlutsky, None; V.M. Flood, None; T.Y. Wong, None; P. Mitchell, None.
  • Footnotes
    Support  Australian NHMRC grant nos. 974159 and 991407
Investigative Ophthalmology & Visual Science April 2009, Vol.50, 104. doi:
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      B. Gopinath, J. J. Wang, G. Burlutsky, V. M. Flood, T. Y. Wong, P. Mitchell, Blue Mountains Eye Study; The Associations Between Retinal Vascular Caliber and Homocysteine, Folate and Vitamin B12 Levels. Invest. Ophthalmol. Vis. Sci. 2009;50(13):104.

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Abstract

Purpose: : Investigators of the Hoorn Study observed a significant association between high total plasma homocysteine levels and retinal arteriolar narrowing. We aimed to assess the association between serum homocysteine, serum folate and vitamin B12 levels with retinal vascular caliber in the Blue Mountains Eye Study (BMES) population.

Methods: : Of 2,335 BMES participants re-examined in 1997-9, 1,772 had retinal photographs taken to measure retinal arteriolar and venular caliber. Serum homocysteine, folate and vitamin B12 levels were determined using venous blood samples. Multivariable adjusted linear regression models were used to assess continuous associations with retinal vessel caliber and non-linear models were used to assess threshold effects on associations of homocysteine levels with retinal vascular caliber.

Results: : After adjusting for age, sex, fasting blood glucose, smoking and mean arterial blood pressure, persons with homocysteine level >20 µmol/L (clinical cut off) had significantly narrower mean retinal arteriolar diameter (189.3 µm) than those with homocysteine lower than this level (193.6 µm, p=0.01). However, in linear regression models, this association was not statistically significant (p=0.15). Further investigation showed a significant gender interaction (p=0.04), with associations seen only in men. Among men, a threshold effect was detected at a serum homocysteine level of 14 µmol/L, above which, increasing homocysteine level was associated with narrower arteriolar diameter (narrowing of 0.586 µm per 1.0 µmol/L increase in homocysteine levels), but below this threshold, no significant association was found. We found no associations of serum folate or B12 levels with retinal arteriolar or venular caliber.

Conclusions: : We detected a significant association between elevated serum homocysteine level and retinal arteriolar caliber narrowing in men, with a threshold at 14 µmol/L. A possible mechanism could be that elevated homocysteine is more frequent in men, and may affect the retinal microvasculature by its effects on oxidative and inflammatory processes and endothelial cell dysfunction.

Keywords: nutritional factors • retina • clinical (human) or epidemiologic studies: outcomes/complications 
© 2009, The Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Permission to republish any abstract or part of an abstract in any form must be obtained in writing from the ARVO Office prior to publication.
Copyright © 2025 Association for Research in Vision and Ophthalmology.
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