Elsevier

Ophthalmology

Volume 107, Issue 8, 1 August 2000, Pages 1588-1592
Ophthalmology

Hyperhomocystinemia in patients with nonarteritic anterior ischemic optic neuropathy, central retinal artery occlusion, and central retinal vein occlusion1,

Presented in part at the annual meeting of the American Academy of Ophthalmology, Orlando, Florida, October 1999.
https://doi.org/10.1016/S0161-6420(00)00181-0Get rights and content

Abstract

Objective

This study aimed to determine the prevalence of hyperhomocystinemia among patients with nonarteritic anterior ischemic optic neuropathy (NAION), central retinal artery occlusion (CRAO), or central retinal vein occlusion (CRVO).

Design

Retrospective, case-control study.

Participants

The study cohort consisted of 74 consecutive patients with NAION, CRAO, or CRVO who were examined at the Retina or Neuro-ophthalmological Unit of the Tel-Aviv Sourasky Medical Center from 1998 through 1999. The control group consisted of 81 consecutive patients of similar gender and age with no history of these pathologic conditions.

Main outcome measures

Plasma homocystine levels of all study participants were obtained.

Results

Eighteen of 40 patients (45%) with NAION and eight of 13 patients (61.5%) with CRAO had hyperhomocystinemia compared with three of 21 (14.3%) in the CRVO group (P < 0.001) and eight (9.8%) in the control group (P < 0.0001). Hypertension and ischemic heart disease were significantly more prevalent in the NAION patients with elevated plasma homocystine.

Conclusions

Our findings suggest that hyperhomocystinemia is a risk factor for NAION and CRAO.

Section snippets

Patients and methods

All consecutive patients with NAION, CRAO, or CRVO seen at the Retina or Neuro-ophthalmological Unit of the Tel-Aviv Sourasky Medical Center from July 1998 through March 1999 and who agreed to participate in the study were included. Because of the low number of consecutive patients with CRAO seen at our institution during this period (n = 5), we also retrieved the charts of all the patients with CRAO seen in previous years and invited them to participate in the study (n = 8).

A detailed medical

Results

Seventy-four patients (41 males, 33 females) with NAION, CRAO, or CRVO were included in the study group. The control group consisted of 81 healthy adults of similar age and sex (Table 1). The mean age of the NAION and the CRAO groups was not significantly different from the controls (P > 0.5), but the patients in the CRVO group were significantly younger than the controls (P < 0.005).

The mean plasma homocystine level was statistically significantly elevated in the NAION (P = 0.0088) and the

Discussion

The results of our study suggest that the prevalence of hyperhomocystinemia in patients with arterial occlusion (NAION or CRAO) is significantly increased. Moreover, in the NAION group, patients with hyperhomocystinemia had a significantly higher incidence of hypertension and ischemic heart disease. A similar trend was seen for the CRAO group, but the sample was too small to be statistically significant.

In our previous study,44 we investigated the incidence of homozygosity to MTHFR mutation in

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    1

    Received October 23, 1999. Accepted March 28, 2000.

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