Hyperhomocysteinemia: a risk factor for central retinal vein occlusion

Am J Ophthalmol. 2000 May;129(5):640-4. doi: 10.1016/s0002-9394(99)00476-6.


Purpose: Previous studies have documented that elevated plasma homocysteine level is a risk factor for vascular disease. This study was performed to determine whether hyperhomocysteinemia is a risk factor for central retinal vein occlusion.

Methods: In a case-control study, data from 74 patients with documented central retinal vein occlusion were reassessed. Control subjects consisted of individuals referred to the same clinic for assessment of a nonretinal vascular disease. Hyperhomocysteinemia was defined as a total plasma homocysteine level above the 95th percentile in the control group.

Results: The mean total plasma homocysteine level was 11.58 +/- 4.67 micromol/l (range, 5-26 micromol/l) for cases, and 9.49 +/- 2.65 micromol/l (range, 5-20 micromol/l) for control subjects. Of the 74 patients with a central retinal vein occlusion, 16 (21.6%) had total plasma homocysteine levels above the 95th percentile in the control group (odds ratio, 6.53; 95% confidence interval, 1.81-23.50; P =. 003). Hyperhomocysteinemia was present in five (55%) of the nine individuals with bilateral disease, nine (30%) of the 30 patients with ischemic occlusions, and 45 (31%) of the 83 eyes with severe visual loss.

Conclusion: Hyperhomocysteinemia is a risk factor for central retinal vein occlusion and may suggest a poor prognosis in patients with central retinal vein occlusion.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Female
  • Homocysteine / blood
  • Humans
  • Hyperhomocysteinemia / blood
  • Hyperhomocysteinemia / complications*
  • Male
  • Middle Aged
  • Odds Ratio
  • Prognosis
  • Retinal Vein Occlusion / blood
  • Retinal Vein Occlusion / etiology*
  • Risk Factors


  • Homocysteine