Hyperhomocystinemia in Pseudoexfoliation Glaucoma

Leibovitch, Igal; Kurtz, Shimon; Shemesh, Gabi; Goldstein, Michaella; Sela, Ben‐Ami; Lazar, Moshé; Loewenstein, Anat

doi:10.1097/00061198-200302000-00007

Cited by 78 publications

(64 citation statements)

References 25 publications

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“…Coffee consumption has been shown to increase plasma homocysteine (Hcy) levels in several randomized clinical trials. [18][19][20] Hcy levels in plasma, [21][22][23][24][25][26] aqueous humor, 27 and tear fluid 28 are consistently elevated in ES patients compared to those in control subjects. Elevated Hcy may enhance exfoliation material formation by contributing to vascular damage, 29 oxidative stress, 30,31 and extracellular matrix alterations.…”

Section: Resultsmentioning

confidence: 91%

“…Several studies show that Hcy levels are elevated in blood, aqueous humor, and tears taken from ES patients compared to those in controls. [21][22][23][24][25][26][27][28] Elevated Hcy levels, in turn, may contribute to vascular leakage and dysfunctional extracellular matrix remodeling in ES. 54 Alternatively, elevated Hcy levels are a consequence and not a cause of ES, and some unlinked factor(s) related to heavy coffee consumption may contribute to EG/EGS.…”

Section: Discussionmentioning

confidence: 99%

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The Relationship between Caffeine and Coffee Consumption and Exfoliation Glaucoma or Glaucoma Suspect: A Prospective Study in Two Cohorts

Pasquale

Wiggs

Willett

et al. 2012

Invest. Ophthalmol. Vis. Sci.

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PURPOSE. We examined the association between caffeine and caffeinated beverage consumption in relation to the risk of exfoliation glaucoma or exfoliation glaucoma suspect (EG/ EGS). METHODS.We followed 78,977 women from the Nurses' Health Study (NHS) and 41,202 men from the Health Professionals Follow-up Study (HPFS) who were at least 40 years of age, did not have glaucoma, and reported undergoing eye examinations from 1980 (NHS) or 1986 (HPFS) to 2008. Information on consumption of caffeine-containing beverages and potential confounders were repeatedly ascertained in validated followup questionnaires. Confirmation with medical record review revealed 360 incident EG/EGS cases. Multivariate rate ratios (RRs) for EG/EGS were calculated in each cohort and then pooled using meta-analytic techniques.RESULTS. Compared with participants whose cumulatively updated total caffeine consumption was <125 mg/day, participants who consumed ‡500 mg/day had a trend toward increased risk of EG/EGS that was not statistically significant (RR ¼ 1.43; 95% confidence interval [CI], 0.98-2.08); P trend ¼ 0.06). Compared to abstainers, those who drank ‡3 cups of caffeinated coffee daily were at increased risk of EG/EGS (RR ¼ 1.66; 95% CI, 1.09-2.54; P trend ¼ 0.02). These results were not materially altered after adjustment for total fluid intake. Associations were stronger among women with a family history of glaucoma (P interaction ¼ 0.06 for coffee; P interaction ¼ 0.03 for caffeine). We did not find associations with consumption of other caffeinated products (caffeinated soda, caffeinated tea, decaffeinated coffee or chocolate) and risk of EG/EGS (P trend ‡0.31).CONCLUSIONS. We observed a positive association between heavier coffee consumption with risk of EG/EGS in this large prospective study. (Invest Ophthalmol Vis Sci. 2012;53:6427-6433)

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Section: Resultsmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

The Relationship between Caffeine and Coffee Consumption and Exfoliation Glaucoma or Glaucoma Suspect: A Prospective Study in Two Cohorts

Pasquale

Wiggs

Willett

et al. 2012

Invest. Ophthalmol. Vis. Sci.

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“…Hyperhomocysteinaemia, which is a major risk factor for vascular diseases (including venous thrombosis), was reported to be more common in XFS and XFG patients than in healthy controls in several studies. [39][40][41][42] Finally, endothelin-1, which is a potent vasoconstrictor, seems to be significantly increased in the aqueous of XFS eyes, which could contribute to the obliterative vasculopathy. 43 Elevated IOP and glaucoma have also been suggested as a cause for the association of XFS with CRVO.…”

Section: Discussionmentioning

confidence: 99%

Retinal vascular occlusions occur more frequently in the more affected eye in exfoliation syndrome

Prata

Rozenbaum

Moraes

et al. 2009

Eye

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Purpose To evaluate the relationship between retinal vascular occlusions (RVOs) and exfoliation syndrome (XFS) in a cohort of patients with the two conditions. Methods We reviewed the records of patients with XFS with or without glaucoma and any type of RVO between 1983 and 2007. Patients with prior incisional surgery or a history of uveitis were excluded. Data collected included demographics, systemic comorbidities, type of RVO, and intraocular pressure (IOP) before the RVO. Slit-lamp biomicroscopy regarding the presence of exfoliation material on the lens capsule and pupillary margin before the vascular event was used to evaluate the laterality and degree of XFS. Results We identified 36 patients (mean age 78.4±8.3 years, 19 women). Most patients were of European descent (34/36) and 20 (56%) had no prior glaucoma diagnosis. The most common retinal vascular events were central retinal vein occlusion (18/36) and BRVO (10/36). Mean IOP between eyes with (19.5 ± 6.5 mm Hg) and without (17.9 ± 4.8 mm Hg) RVO was similar (P ¼ 0.12). RVOs occurred more commonly in the eye with more pronounced XFS in 92% (33/36) of the cases. A similar agreement was found when considering patients with and without glaucoma separately (94% (15/16) vs 90% (18/20); P ¼ 0.83). In addition, no difference in the agreement percentage was observed when comparing patients with unilateral XFS (87% (13/15)) with all study patients (P ¼ 0.87). Conclusions Retinal vascular occlusion in patients with XFS occurs most often in the affected or more severely affected eye.As vascular occlusions happened in patients with and without glaucoma in similar proportions, the presence of XFS seems to play an important role in these findings.

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“…Increased plasma homocysteine has been reported in pseudo-exfoliative 17,18 but not in primary angle glaucoma. 19 Studies have shown increased plasma homocysteine in patients with age-related macular degeneration.…”

Section: Diabetic Retinopathymentioning

confidence: 95%

Homocysteine, folates, and the eye

Wright

Martin

Dodson

2007

Eye

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Hyperhomocystinemia in Pseudoexfoliation Glaucoma

Abstract: Hyperhomocystinemia may be associated with pseudoexfoliation glaucoma, which may partially explain the increased risk of vascular diseases among patients with pseudoexfoliation syndrome.

Cited by 78 publications

References 25 publications

The Relationship between Caffeine and Coffee Consumption and Exfoliation Glaucoma or Glaucoma Suspect: A Prospective Study in Two Cohorts

The Relationship between Caffeine and Coffee Consumption and Exfoliation Glaucoma or Glaucoma Suspect: A Prospective Study in Two Cohorts

Retinal vascular occlusions occur more frequently in the more affected eye in exfoliation syndrome

Homocysteine, folates, and the eye

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