Purpose Hyperhomocysteinaemia has been linked to macrovascular disease. Our
aim was to investigate whether there is a relationship between fasting pla
sma total homocysteine levels and retinal vascular disease.
Methods We measured the homocysteine levels in 70 patients with arterial or
venous retinal vessel occlusion and compared them with the levels in 85 co
ntrols without evidence of ischaemic heart disease. Homocysteine levels wer
e determined by high-performance liquid chromatography with electrochemical
detection and compared after logarithmic transformation.
Results Homocysteine levels were found by univariate analysis (unpaired two
-tailed t-test) to be significantly higher in the group with retinal artery
occlusion than the group with retinal vein occlusion (p = 0.045) and in bo
th groups compared with controls (18.4 and 13.8 vs 9.5 mu mol/l; p = 0.0002
and < 0.0001, respectively). The controls, however, were significantly you
nger than the subjects (51.5 +/- 15.4 vs 66.2 +/- 11.9 years; p < 0.0001),
but analysis of the results by age revealed significant differences between
the groups and controls for the seventh decade (vein occlusions, p = 0.05)
and for the eighth decade (artery occlusions, p = 0.037). Subgroup analysi
s of the retinal vessel occlusion group revealed significant differences in
mean blood pressure between those with branch retinal vein occlusions (175
/100 mmHg) and both those with central retinal vein occlusions (155/88 mmHg
) and those with retinal artery occlusions (157/86 mmHg). Both vein occlusi
on subgroups also differed significantly with regard to homocysteine levels
, branch < central (12.2 +/- 1.3 vs 15.0 +/- 1.6 mu mol/l, p = 0.03). Multi
ple linear regression analysis revealed significant relationships between h
omocysteine levels and the presence of retinal vessel occlusion (p = 0.0002
), serum creatinine (p = 0.001) and age (p = 0.003), but not gender.
Conclusions We conclude that homocysteine may be a risk factor for retinal
vascular disease and could be simply and cheaply treated with folate and vi
tamins B-6 and B-12.