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 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. Plasma homocystine 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 American Academy of Ophthalmology.