Abstract
Few studies have reported the relationship between retinal artery occlusion (RAO) and plasma homocysteine (Hcy) levels. Our goal was to evaluate the association between the plasma Hcy level and the risk of RAO disease. Several databases were searched for all published studies that involved Hcy and RAO. Six studies evaluated hyperhomocysteinemia (hHcy) in retinal artery occlusion patients and controls; the incidence of hHcy in patients with RAO was higher than the control and the pooled odds ratio (OR) was 6.64 (95% confidence interval (CI): 3.42, 12.89). Subgroup analyses showed that the ORs were 4.77 (95% CI: 2.69, 8.46) in Western countries, 22.19 (95% CI: 2.46, 200.37) in Asian countries, 9.70 (95% CI: 4.43, 21.20) in the age matched group, 11.41 (95% CI: 3.32, 39.18) in the sex matched group, 9.70 (95% CI: 4.37, 21.53) in the healthy control group, and 6.82 (95% CI: 4.19, 11.10) in the sample size >30. The mean plasma Hcy level from 5 case-control studies was higher than controls, and the weighted mean difference (WMD) was 6.54 (95% CI: 2.79, 10.29). Retinal artery occlusion is associated with elevated plasma Hcy levels. Our study results suggest that hHcy is probably an independent risk factor for RAO.
Highlights
Retinal artery occlusion (RAO) is a cause of ocular morbidity that mainly affects patients older than 60 years[1] and occurs in young people[2,3], and no proven therapy exists[4,5]
Thrombophilia is a complex hypercoagulable state that increases the risk of thrombosis
It plays a significant pathoetiologic role in the development of retinal artery occlusion (RAO), which is associated with stroke, coronary artery disease, atrial fibrillation, and carotid stenosis[35]
Summary
Retinal artery occlusion (RAO) is a cause of ocular morbidity that mainly affects patients older than 60 years[1] and occurs in young people[2,3], and no proven therapy exists[4,5]. When patients present with RAO, ophthalmologists should ensure that they receive appropriate acute and secondary preventive treatment[8,11] because it is an important warning of cardiovascular and cerebrovascular events[12,13,14,15] This means that patients with incidents of RAO are at increased risk of cardiovascular disease and ischaemic stroke[15,16,17,18]. The association between Hcy and the risk of RAO has been reported in some studies[24,25,26,27,28,29,30,31,32], but the conclusion is contradictory and inconclusive, partially due to the relatively small sample size of individual studies, sampling effects and lack of statistical power.
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