Diagnostic efficacy of total homocysteine and C-reactive protein for ocular ischemic syndrome

Abstract

Background To assess diagnostic efficacy of plasma total homocysteine (tHcy) and C-reactive protein (CRP) levels for ocular ischemic syndrome (OIS). Methods In all, 87 patients with retinal vein occlusion (RVO), 955 patients with a stenosis of internal carotid artery (ICA) o90% and 159 patients with a stenosis of ICA 490% were included between 2003 and 2009. A total of 43 patients with a stenosis ICA 490% were diagnosed as OIS. Fasting tHcy, CRP, lipid profiles, creatinine were measured, and diagnostic values of hyperhomocysteinemia or elevated CRP for OIS were evaluated. Result The mean plasma levels of tHcy (18.8 lmol/l) and CRP (1.1 mmol/l) were the highest in patients with OIS among the groups. The prevalences of hyperhomocysteinemia (72%) and elevated CRP (77%) were the highest in OIS among the groups. In patients with stenosis of ICA, the diagnostic sensitivity/specificity for OIS was 70/79% in hyperhomocysteinemia and 73/73% in elevated CRP. The diagnostic sensitivity and specificity for OIS were 53 and 86% in both hyperhomocysteinemia and elevated CRP. The lipid profiles and creatinine levels were similar among the groups. Conclusion Our results suggest that hyperhomocysteinemia and elevated CRP may be associated with the development of OIS. The measurements of tHcy and CRP in blood may help to assist the diagnosis of OIS in a stenosis of ICA.

Incidence and Risk Factors for Ocular Ischemic Syndrome in Patients with Complete Internal Carotid Artery Occlusion

“…7 Previous studies have suggested that the tHcy levels is a marker of atherosclerosis. 9 Our study demonstrated high tHcy levels in the blood in patients with OIS and complete internal carotid artery occlusion. A previous study demonstrated that tHcy levels were associated with the development of OIS in patients with preexisting stenosis of the internal carotid artery.…”

“…A previous study demonstrated that tHcy levels were associated with the development of OIS in patients with preexisting stenosis of the internal carotid artery. 9 The sensitivity and speci city of hyperhomocysteinemia for diagnosing OIS in patients with stenosis of the internal carotid artery were 70% and 79%, respectively. 9 In patients with preexisting carotid artery diseases, elevated tHcy levels in the blood are considered a risk factor for the future development of stroke.…”

“…9 The sensitivity and speci city of hyperhomocysteinemia for diagnosing OIS in patients with stenosis of the internal carotid artery were 70% and 79%, respectively. 9 In patients with preexisting carotid artery diseases, elevated tHcy levels in the blood are considered a risk factor for the future development of stroke. 9 We found that three patients with OIS suffered a stroke during hospitalization.…”

“…9 In patients with preexisting carotid artery diseases, elevated tHcy levels in the blood are considered a risk factor for the future development of stroke. 9 We found that three patients with OIS suffered a stroke during hospitalization. The 5-year survival rate for patients with OIS is only 60%; thus, an astute clinical diagnosis, targeted workup for systemic examination, and prompt referral are important for patients with OIS.…”

Ocular Ischemic Syndrome

“…Ocular Ischemic Syndrome the ophthalmic artery in patients with maxillofacial arteriovenous malformation [ 35 ], associated with Eisenmenger's syndrome [ 36 ], mucormycosis [ 37 ], moyamoya [ 38 ], chronic herpes simplex keratouveitis [ 39 ], strabismus fi xus convergens [ 40 ], and hyperhomocysteinemia [ 41 ]. I have also seen it develop following prolonged nonophthalmic surgeries, e.g., spinal region surgery, orbital trauma, and, in one case, following shoulder surgery in a sitting position with pressure on the eyes.…”