Vine A K
Retina Service, University of Michigan Kellogg Eye Center, Ann Arbor, Michigan 48105, USA.
Am J Ophthalmol. 2000 May;129(5):640-4. doi: 10.1016/s0002-9394(99)00476-6.
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.
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.
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.
Hyperhomocysteinemia is a risk factor for central retinal vein occlusion and may suggest a poor prognosis in patients with central retinal vein occlusion.
既往研究已证明血浆同型半胱氨酸水平升高是血管疾病的一个危险因素。本研究旨在确定高同型半胱氨酸血症是否为视网膜中央静脉阻塞的危险因素。
在一项病例对照研究中，对74例有记录的视网膜中央静脉阻塞患者的数据进行重新评估。对照对象为由因非视网膜血管疾病到同一诊所进行评估的个体组成。高同型半胱氨酸血症定义为血浆总同型半胱氨酸水平高于对照组的第95百分位数。
病例组血浆总同型半胱氨酸水平的均值为11.58±4.67微摩尔/升（范围5 - 26微摩尔/升），对照组为9.49±2.65微摩尔/升（范围5 - 20微摩尔/升）。在74例视网膜中央静脉阻塞患者中，16例（21.6%）的血浆总同型半胱氨酸水平高于对照组的第95百分位数（比值比，6.53；95%置信区间，1.81 - 23.50；P = 0.003）。在9例双侧患病个体中有5例（55%）存在高同型半胱氨酸血症，30例缺血性阻塞患者中有9例（30%），83只严重视力丧失的眼中有45只（31%）。
高同型半胱氨酸血症是视网膜中央静脉阻塞的一个危险因素，可能提示视网膜中央静脉阻塞患者预后不良。
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