Abstract
There is a strong association between severe hyperhomocysteinemia and myopia. Thus we studied the hypothesis that even moderately increased levels of homocysteine (Hcy) might be a potentially treatable risk factor for myopia. The Gutenberg Health Study (GHS) is a population-based, prospective, observational cohort study in Germany, including 15,010 participants aged between 35 and 74 at recruitment. The baseline examination was conducted from 2007-2012. Refraction was measured using autorefraction (HARK 599, Carl Zeiss AG, Jena, Germany). Hcy was measured by an immunoassay. We included only phakic participants without a history of corneal surgery or corneal laser treatment. We used linear regression models to evaluate the potential association between Hcy and refraction at baseline, and between Hcy and change in refraction between baseline and 5-year-follow-up examination. We used generalized estimating equation models to account for the correlation between fellow eyes. We included 13,749 participants, categorized as having no myopia (spherical equivalent > -0.75 D, 65.2%), low myopia (-0.75 D--2.75 D, 21.5%), moderate myopia (-3.00 D- 5.75 D, 9.8%) and high myopia (≤ -6 D, 3.5%). Median Hcy levels were similar in all groups (μmol/l). We observed no association of Hcy with refraction or 5-year change in refraction in the models adjusted for age, sex and socioeconomic status. We found no evidence for an association of Hcy levels and refractive error.
Highlights
Myopia is a worldwide increasing health challenge requiring optical aids such as glasses or contact lenses and increasing the risk of severe secondary eye diseases such as glaucoma, cataract and macular degeneration [1]
Median Hcy levels were similar in all groups
We observed no association of Hcy with refraction or 5-year change in refraction in the models adjusted for age, sex and socioeconomic status
Summary
Myopia is a worldwide increasing health challenge requiring optical aids such as glasses or contact lenses and increasing the risk of severe secondary eye diseases such as glaucoma, cataract and macular degeneration [1]. Both hereditary and environmental risk factors have been identified or suspected [2]. In a cohort of patients with late-diagnosed hyperhomocysteinemia, all 14 had lens subluxation or dislocation at diagnosis [7]. Given the very strong association between severe hyperhomocysteinemia and myopia, we hypothesized that even moderately increased levels of Hcy might be a risk factor for myopia [3, 8]. We assume that moderately increased Hcy would be present over the entire life span and could be detected in our adult study sample
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