Serum homocysteine, vitamin B 12 and folic acid levels in different types of glaucoma

Tongabay Cumurcu,Semsettin Sahin,Erdinc Aydin

doi:10.1186/1471-2415-6-6

Abstract

BackgroundThis study was performed to compare levels of serum homocysteine (Hcy), vitamin B12 and folic acid in patients with primary open-angle glaucoma (POAG), pseudoexfoliative glaucoma (PEXG), normotensive glaucoma (NTG) and healthy controls.MethodsTwentyfive patients with POAG, 24 with PEXG, and 18 with NTG, along with 19 control healthy subjects were included this prospective study. Levels of serum Hcy were measured using immunoassay, and those of serum vitamin B12 and folic acid were measured using competitive chemiluminescent enzyme immunoassay.ResultsThe mean Hcy concentration in the PEXG group was significantly higher (P < 0.001) as compared to the other groups. There were no significant differences with respect to the mean Hcy concentrations among other groups (P > 0.05). There were no statistical differences in serum vitamin B12 levels among POAG, PEXG, NTG and control subjects (P > 0.05).The mean serum folic acid level was significantly lower in the subjects with PEXG (P < 0.009). However, the mean folic acid concentrations among the other groups did not differ significantly (P > 0.05).ConclusionElevated levels of Hcy in PEXG may explain the role of endothelial dysfunction among patients with PEXG.

Highlights

This study was performed to compare levels of serum homocysteine (Hcy), vitamin B12 and folic acid in patients with primary open-angle glaucoma (POAG), pseudoexfoliative glaucoma (PEXG), normotensive glaucoma (NTG) and healthy controls
Elevated levels of Hcy in PEXG may explain the role of endothelial dysfunction among patients with PEXG
The aim of this study is to evaluate the role of serum Hcy, vitamin B12 and folic acid levels in patients with POAG, PEXG, and NTG, and compare them to sex and agematched group of control healthy subjects

Summary

Introduction

This study was performed to compare levels of serum homocysteine (Hcy), vitamin B12 and folic acid in patients with primary open-angle glaucoma (POAG), pseudoexfoliative glaucoma (PEXG), normotensive glaucoma (NTG) and healthy controls. Impaired microcirculation and abnormal perfusion may cause glaucomatous damage in the optic nerve head. Anatomical or functional abnormalities of the vessels of the optic nerve head such as arteriosclerosis or vascular dysregulation might be the causative factor [1,2]. The metabolism of methionine via homocysteine (Hcy) to cysteine is a complex pathway involving an enzyme depending on vitamin B12, B6, and folic acid. Inherited defects are the most important determinants of elevated levels of Hcy. Some studies showed that elevated Hcy may increase the risk of retinal vascular diseases, such as retinal artery and vein occlusion and non-artheritic ischemic optic neuropathy [3,4,5,6,7]. Hcy-induced vascular problem may be a multifactorial case, including direct toxic damage to the endothelium, stimulation of prolifer-

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