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Purpose: Our aim was a) to compare serum Hcy levels in patients with RVO and population-based controls, and b) to evaluate whether hyperhomocysteinemia is a risk factor for RVO. Patients and methods: Prospective case-control study of all patients diagnosed with RVO at a tertiary-care hospital, and age-and sex-matched controls taking part in a population-based prospective cohort in the same geographic area. Differences in serum Hcy between both groups were analyzed by a general linear model adjusted for age, body mass index (BMI), glomerular filtration rate (GFR), hypertension, dyslipidemia, diabetes, tobacco use and alcohol intake. Besides, we tested the relationship between hyperhomocysteinemia (> 15 μmol/L) and RVO, by a stepwise logistic regression analysis. Results: RVO patients (n = 85) had a higher prevalence of hypertension (p = 0.002), diabetes (p = 0.008), and dyslipidemia (p = 0.04) than controls (n = 82). Adjusted median Hcy levels were higher in RVO patients (p < 0.0001). Adjusted OR for hyperhomocysteinemia were 4.4 (95% CI, 2.0-9.3; p < 0.0001) in the overall sample, and 2.6 (95% CI, 1.04-6.6; p = 0.04) and 6.1 (95% CI, 1.7-21.6; p = 0.005) for men and women, respectively. Conclusion: Patients with RVO have higher serum Hcy levels than ageand sex-matched population-based controls. Hyperhomocysteinemia seems to be a risk factor for RVO, independent of age, BMI, GFR and classical vascular risk factors.

Serum Homocysteine Levels in Patients with Retinal Vein Occlusion in a Spanish Population