Hyperhomocysteinemia and central retinal vein occlusion in Iranian population

To evaluate total plasma homocysteine level during the acute phase of central retinal vein occlusion [CRVO] compared with a matched healthy group in Iranian population, and determine whether hyperhomocysteinemia is also a risk factor for CRVO. A study group contains 54 patients presenting with CRVO in recent one month, acute phase of the decease, was compared for fasting total plasma homocysteine level with a matched control group of 51 patients evaluated in the same clinic for a non retinal disease diagnosis. The mean total plasma homocysteine level was 14.76 +/- 7.67 micro mol/l in cases, and 11.42 +/- 3.74 micro mol/l in control subjects. It shows a significant difference [p=0.005] in mean plasma homocysteine level between the cases and control group. Odds ratio of CRVO for individuals with hyperhomocysteinemia was 2.88 [95% Cl=1.08-7.71 and p=0.03]. The overall multivanable-adjusted odds of CRVO in participants with plasma homocysteine level above 15 micro mol/l was 4.71 [95% Cl=1.46-15.19 and p=0.009] Hyperhomocysteinemia was not statistically different in each age group [<60 years: 27%. 61-70 years: 33.3%, 71-80 years: 31.6%, >81 years: 33.3%], Chi-square test, p=0.98]. Elevated total plasma homocysteine level is an independent risk factor for CRVO in Iranian population. In addition to an evaluation of all conventional cardiovascular risk factors, measurement of total homocysteine for evidence of hyperhomocysteinemia may be important in the initial investigation and management of patients with CRVO

Comparison of the effect of adjuvant 5-fluorouracil, low molecular weight heparin and daunomycin in combination with triamcinolone during vitrectomy in advanced retinal detachment

To compare the success rate of adjunctive 5-fluorouracil [5-FU] and low molecular weight heparin [LMWH], and daunomycin in combination with triamcinolone during vitrectomy in eyes with retinal detachment [RD] and proliferative vitreoretinopathy [PVR]. In this prospective randomized clinical trial, 69 eyes from 69 patients with RD and PVR [grade B or C] randomized to 3 groups. Group 1: received 5-FU and LMWH [200 microgram/ml 5-FU and 5 IU/ml LMWH, Fragmin]; group 2: received daunomycin [0.5 mg] in 500 cc infusion fluid; and group 3: control group. In all patients, 0.1 cc intravitreal triamcinolone was used during vitrectomy. The patients visited on day 1, week 1, month 1, 3 and 6. Best corrected visual acuity [BCVA] and retinal status compared in the 3 groups. Complete data were available for 60 out of 69 patients. Thirty five patients [58.3%] were male and 25 patients [41.7%] were female. The patient age range was 19-84 years and the mean age was 49. The groups did not have significant difference in age, sex, duration of detachment, severity of PVR, preoperative visual acuity [V/A], lens status, type of tamponade and encircling band and buckle. Postoperative V/A and retina status also was the same in the 3 groups. Perioperative infusion of 5-FU, LMWH and daunomycin does not significantly increase the success rate of patients with RD and PVR comparing to control group. Although visual acuity improvement and retina reattachment rate in group 1 and 2 were better than control group, but statistical analysis failed to show significant difference between the 3 groups