Abstract
Background
To assess diagnostic efficacy of plasma total homocysteine (tHcy) and C-reactive protein (CRP) levels for ocular ischemic syndrome (OIS).
Methods
In all, 87 patients with retinal vein occlusion (RVO), 955 patients with a stenosis of internal carotid artery (ICA) <90% and 159 patients with a stenosis of ICA >90% were included between 2003 and 2009. A total of 43 patients with a stenosis ICA >90% were diagnosed as OIS. Fasting tHcy, CRP, lipid profiles, creatinine were measured, and diagnostic values of hyperhomocysteinemia or elevated CRP for OIS were evaluated.
Result
The mean plasma levels of tHcy (18.8 μmol/l) and CRP (1.1 mmol/l) were the highest in patients with OIS among the groups. The prevalences of hyperhomocysteinemia (72%) and elevated CRP (77%) were the highest in OIS among the groups. In patients with stenosis of ICA, the diagnostic sensitivity/specificity for OIS was 70/79% in hyperhomocysteinemia and 73/73% in elevated CRP. The diagnostic sensitivity and specificity for OIS were 53 and 86% in both hyperhomocysteinemia and elevated CRP. The lipid profiles and creatinine levels were similar among the groups.
Conclusion
Our results suggest that hyperhomocysteinemia and elevated CRP may be associated with the development of OIS. The measurements of tHcy and CRP in blood may help to assist the diagnosis of OIS in a stenosis of ICA.
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References
Mizener JB, Podhajsky P, Hayreh SS . Ocular ischemic syndrome. Ophthalmology 1997; 104: 859–864.
Young LH, Appen RE . Ischemic oculopathy. A manifestation of carotid artery disease. Arch Neurol 1981; 38: 358–366.
Sivalingam A, Brown GC, Magargal LE . The ocular ischemic syndrome. III. Visual prognosis and the effect of treatment. Int Ophthalmol 1991; 15: 15–20.
Yoo JH, Chung CS, Kang SS . Relation of plasma homocysteine to cerebral infarction and cerebral atherosclerosis. Stroke 1998; 29: 2478–2483.
Cahill MT, Stinnett SS, Fekrat S . Meta-analysis of plasma homocysteine, serum folate, serum vitamin B12, and thermolabile MTHFR genotype as risk factors for retinal vascular disease. Am J Ophthalmol 2003; 136: 1136–1150.
Pinna A, Carru C, Zinellu A, Dore S, Deiana L, Carta F . Plasma homocysteine and cysteine levels in retinal vein occlusion. Invest Ophthalmol Vis Sci 2006; 47: 4067–4071.
Di Crecchio L, Parodi MB, Sanguinetti G, Iacono P, Ravalico G . Hyperhomocysteinemia and the methylenetetrachydrofolate reductase 677C-T mutation in patients under 50 years of age affected by central retinal vein occlusion. Opthalmology 2004; 111: 940–945.
Ross R . Atherosclerosis-an inflammatory disease. N Engl J Med 1999; 340: 115–126.
Ledule TB, Weiner DL, Sipe JD, Poulin SE, Collins MF, Rifai N . Analytical evaluation of particle-enhanced immunonephelometric assays for C-reactive protein, serum amyloid A, and mannose-binding protein in human serum. Ann Clin Biochem 1998; 35: 745–753.
Corrado E, Rizzo M, Coppola G, Fattouch K, Novo G, Marturana I et al. An update on the role of markers of inflammation in atherosclerosis. J Artheroscler Thromb 2010; 17: 1–11.
The Homocysteine Studies Collaboration. Homocysteine and risk of ischemic heart disease and stroke. A meta-analysis. JAMA 2002; 288: 2015–2022.
Hackam DG, Anand SS . Emerging risk factors for atherosclerotic vascular disease. A critical review of the evidence. JAMA 2003; 290: 932–940.
Tanne D, Haim M, Goldbourt U, Boyko V, Doolman R, Adler Y et al. Prospective study of serum homocysteine and risk of ischemic stroke among patients with preexisting coronary heart disease. Stroke 2003; 34: 632–636.
Ghorbanihaghjo A, Javadzadeh A, Argani H, Nezami N, Rashtchizadeh N, Rafeey M et al. Lipoprotein(a), homocysteine, and retinal arteriorsclerosis. Mol Vis 2008; 14: 1692–1697.
Wong TY, Islam FM, Klein R, Klein BE, Cotch MF, Castro C et al. Retinal vascular caliber, cardiovascular risk factors, and inflammation: The Multi-Ethnic Study of Artherosclerosis (MESA). Invest Ophthalmol Vis Sci 2006; 47: 2341–2350.
Pasceri V, Willerson JT, Yeh ET . Direct proinflammatory effect of C-reactive protein on human endothelial cells. Circulation 2000; 102: 2165–2168.
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Hong, I., Ahn, J., Chang, S. et al. Diagnostic efficacy of total homocysteine and C-reactive protein for ocular ischemic syndrome. Eye 25, 1650–1654 (2011). https://doi.org/10.1038/eye.2011.232
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DOI: https://doi.org/10.1038/eye.2011.232
