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

Objective: This study aimed to determine the prevalence of hyperhomocystine mia among patients with nonarteritic anterior ischemic optic neuropathy (NA ION), central retinal artery occlusion (CRAO), or central retinal vein occl usion (CRVO). Design: Retrospective, case-control study. Participants: The study cohort consisted of 74 consecutive patients with NA ION, CRAO, or CRVO who were examined at the Retina or Neuro-ophthalmologica l Unit of the Tel-Aviv Sourasky Medical Center from 1998 through 1999. The control group consisted of 81 consecutive patients of similar gender and ag e 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 pre valent in the NAION patients with elevated plasma homocystine. Plasma homoc ystine levels of all study participants were obtained. Conclusions: Our findings suggest that hyperhomocystinemia is a risk factor for NAION and CRAO. Ophthalmology 2000 107:1588-1592 (C) 2000 by the Ameri can Academy of Ophthalmology.