Meta-analysis of plasma homocysteine, serum folate, serum vitamin B12, and thermolabile MTHFR genotype as risk factors for retinal vascular occlusive disease - 26/08/11
InternetAdvance publication at ajo.com May 28, 2003
Abstract |
Purpose |
To assess the role of plasma total homocysteine (tHcy) levels, serum folate and vitamin B12levels, and homozygosity for the thermolabile methylenetetrahydrofolate reductase genotype (TT) as risk factors for retinal vascular occlusive disease.
Design |
Meta-analysis of literature.
Methods |
A MEDLINE search was performed to identify all published case–control studies of plasma tHcy levels, serum folate and vitamin B12 levels, and TT genotype in persons with retinal vascular occlusive disease. Main outcome measures included calculation of plasma tHcy, serum folate, and serum vitamin B12 standard differences and odds ratios (OR) of TT genotype between cases and controls.
Results |
In total, 614 patients with all types of retinal vein occlusion had higher plasma tHcy levels than 762 control subjects (standard difference, 0.867; 95% confidence interval [CI] = 0.735, 0.999; P < .001). Plasma tHcy levels were also higher in 154 patients with retinal artery occlusion compared with 358 control subjects (standard difference 1.174; 95% CI = 0.947, 1.402; P < .001). Serum folates, but not vitamin B12 levels, were lower in 287 patients with retinal vascular occlusion than in the same number of control subjects (standard difference, 0.508; 95% CI = 0.340, 0.675; P < .001; and −0.060; 95% CI = −0.024, 0.104; P = .474, respectively). Similar proportions of 690 patients with retinal vein occlusion and 2754 control subjects demonstrated the TT genotype (OR = 1.332; 95% CI = 0.995, 1.783; P = .054) as did 152 patients with retinal artery occlusions and 435 control subjects (OR = 1.716; 95% CI = 0.977, 3.014; P = .060).
Conclusions |
Retinal vascular occlusion is associated with elevated plasma tHcy levels and low serum folate levels, but not serum vitamin B12 levels and TT genotype. Until a prospective multicenter trial is undertaken, plasma tHcy levels and serum folate levels should be determined in patients with retinal vascular occlusions, and dietary supplementation with low doses of folate and vitamin B12 should be considered for affected persons.
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Dr. Stinnett was supported by Clinical Vision Research Development Award EY 11725 from the National Eye Institute, National Institutes of Health. |
Vol 136 - N° 6
P. 1136-1150 - décembre 2003 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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