Weger M., Stanger O., Renner W., Schmut O., Haas A.

Universitäts-Augenklinik, Graz, Österreich

Introduction: Elevated levels of plasma homocysteine are known to be a major risk factor for venous thrombosis and cardiovascular disease. A variety of factors including MTHFR C677T mutation, which is known to play an important role in remethylation of homocysteine, and low plasma folate levels have been shown to increase plasma homocystein levels. The aim of this retrospective case-control study was to investigate a possible association between hyperhomocysteinemia and central retinal vein occlusion.
Material and Methods: We studied 74 consecutive patients with central retinal vein occlusion and 74 age-and sex mathched controls. Plasma homocysteine levels were determined after an overnight fast by HPLC. Plasma folate levels were determined by ELISA and genotyping for the MTHFR C677T mutation was performed by PCR.
Results: Hyperhomocysteinemia was defined to by the 95% percentile of plasma homocysteine concentrations in the control group (14.8 µM/L). Thus, 12 patients with CRVO were diagnosed to be hyperhomocysteinemic compared to 2 control subjects (p=0.005). The odds ratio for those patients was 6.9 (95%Cl:1.5 - 32.3) . Mean plasma folate levels were significantly lower in patients than in controls (4.3 ± 2.1 ng/mL vs. 5.6 ± 2.1 ng/mL; p=0.001). Distribution of MTHFR C677T genotypes did not significantly differ between both groups.
Discussion: Our study suggests that hyperhomocysteinemia, but not the MTHFR C677T mutation is associated with central retinal vein occlusion.

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