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L. Tranchina, L. Liberatoscioli, G. Manni, G. Roberti, F. Oddone, C. Cortese, M. Centofanti; Levels of Plasma Homocysteine in Pseudoexfoliation Glaucoma. Invest. Ophthalmol. Vis. Sci. 2009;50(13):5840.
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To compare levels of serum homocysteine (Hcy), vitamin B12 and folic acid in patients with Pseudoesfoliation glaucoma (PEX), primary open angle glaucoma (POAG), and healthy control subjects.
Diagnosis of PEX was based on the presence of typical exfoliation material on the lens capsule or near the pupil, characteristic glaucomatous optic nerve and visual field damage, and intraocular pressure (IOP) > 21 mmHg. The presence of POAG was defined by IOP > 21 mmHg and typical glaucomatous cupping and visual field loss. Control subjects had no history of ocular disease.Fasting plasma Hcy concentrations and levels of serum vitamin B12 and folic acid were measured using competitive chemiluminescent enzyme immunoassay (ADVIA Centaur, Switzerland). Patients using vitamin supplements or medications known to alter serum Hcy were excluded. Hyperhomocysteinemia was defined as total plasma homocysteine level above 14 UM/l. Mann-Whitney test was used to examine between-group differences in mean values and a p value < 0.05 was considered statistically significant.
Sixteen patients with PEX, 10 with POAG and 17 age-matched healthy subjects were included in this study.Hyperhomocysteinemia was present in 6 of 6 (100%) exfoliation syndrome patients, 8 of 10 (80%) exfoliative glaucoma patients, 3 of 10 (30%) POAG patients and 4 of 17 (23,5%) control subjects. Hcy levels were higher in PEX (19,3±4,4) compared with controls (11,9±7,2 ; p= 0.002) and POAG group ( 11,5±4,1; p<0.001). There were no statistical differences in serum vitamin B12 and folic acid among PEX, PEXG, POAG and controls (p>0.05).
Plasma Hcy is higher in pseudoexfoliation glaucoma patients than healthy controls.Hyperhomocysteinemia is a risk factor for thromboembolic vasculopathy and might play a role in the pathogenesis of PEX. Further studies are necessary to investigate the role of hyper-Hcy in the development of exfoliative disorder.
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