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(Investigative Ophthalmology and Visual Science. 2007;48:1441-1446.)
© 2007 by The Association for Research in Vision and Ophthalmology, Inc.
DOI:  10.1167/iovs.06-0905
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Hyperhomocysteinemia and Low Methionine Stress Are Risk Factors for Central Retinal Venous Occlusion in an Indian Population

Angayarkanni Narayanasamy,1 Barathi Subramaniam,1 Coral Karunakaran,1 Punitham Ranganathan,1 Ramakrishnan Sivaramakrishnan,1 Tarun Sharma,2 Vasanthi Sengamedu Badrinath,3 and Joseph Roy4

1From the Biochemistry Research Department; 2Vitreo-Retinal Services, 3Clinical Laboratory Services, and 4Biostatistics Department, Sankara Nethralaya, Vision and Medical Research Foundation, Chennai, India.

PURPOSE. The underlying cause of disturbed homocysteine metabolism is incompletely understood in young persons with central retinal vein occlusion (CRVO) with mild hyperhomocysteinemia (HHcys) and no other systemic disease in India. A 2-year prospective study was undertaken to determine whether HHcys is a risk factor for CRVO in an Indian population.

METHOD. The prevalence of fasting HHcys was evaluated in a consecutive series of 29 patients with CRVO (mean age, 30 ± 6 years) along with 57 age- and sex-matched control subjects (healthy subjects, mean age 27 ± 5 years). Strict inclusion and exclusion criteria were used. Plasma levels of homocysteine (Hcys), methionine, cysteine, glutathione, B12, and folate were measured. Multivariate logistic regression analysis was performed to determine the risk factors for CRVO.

RESULT. Fifteen of 29 patients with CRVO (51.72%) exhibited HHcys (>15 µM). The mean Hcys level was significantly elevated in the patients with CRVO (19.1 ± 13.1 µM) compared with that in the healthy control subjects (14.7 ± 6.2 µM) with P = 0.04. The increased Hcys levels in CRVO cases was associated with decreased methionine (P = 0.052) and decreased B12 (P = 0.001). A multivariate logistic regression analysis revealed an odds ratio of 1.9 (95% CI = 0.50–7.16) for Hcys and 15.9 for methionine (95%CI = 1.50–169.62; P = 0.022).

CONCLUSION. Elevated Hcys and low methionine were risk factors for CRVO in an Indian population.






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Copyright © 2007 by the Association for Research in Vision and Ophthalmology