Hyperhomocysteinemia (HHcy) and Central Retinal Vein Occlusion (CRVO)

Abstract

Abstract: : Purpose: To evaluate the prevalence and potential implication of HHcy in CRVO. Methods: We considered a consecutive series of 154 patients (mean age: 57.3 yrs) with fluorescein angiography-documented CRVO referred to our Institution over a period of 2.3 yrs; 16 pts (10.4%) had suffered recurrent CRVO. At the time of blood sampling, 58 pts (37.7 %) were 50 yrs or younger. HHcy determined by fasting and post-methionine load ((PML - increment in tHcy over fasting levels 8 hrs after oral intake of D-L methionine, 0.1 g/kg b.w.-) tHcy measurements was established according to gender-specific 95th percentiles of the tHcy distribution in a reference population of 103 apparently healthy controls (median age: 35 yrs) recruited during the time frame of the study. Additional risk factors for CRVO were evaluated. Results: We considered a consecutive series of 154 patients (mean age: 57.3 yrs) with fluorescein angiography-documented CRVO referred to our Institution over a period of 2.3 yrs; 16 pts (10.4%) had suffered recurrent CRVO. At the time of blood sampling, 58 pts (37.7 %) were 50 yrs or younger. HHcy determined by fasting and post-methionine load ((PML - increment in tHcy over fasting levels 8 hrs after oral intake of D-L methionine, 0.1 g/kg b.w.-) tHcy measurements was established according to gender-specific 95th percentiles of the tHcy distribution in a reference population of 103 apparently healthy controls (median age: 35 yrs) recruited during the time frame of the study. Additional risk factors for CRVO were evaluated. Conclusions:Our data support the hypothesis that hyperhomocysteinemia is an indipendent risk factor for CRVO, and that PML tHcy determinations may increase the number of hyperhomocysteinemic pts identified. In view of the relevant incidence of recurrent events, we think that a trial is warranted in HHcy patients with a first episode of CRVO, evaluating the impact of treatment with the vitamins implicated in Hcy metabolism.

Keywords: vascular occlusion/vascular occlusive disease • retina • clinical (human) or epidemiologic studies: ris