Hyperhomocysteinemia, a Biochemical Tool for Differentiating Ischemic and Nonischemic Central Retinal Vein Occlusion during the Early Acute Phase

PURPOSE: The purpose of the study was to differentiate ischemic central retinal vein occlusion (CRVO) from nonischemic CRVO during the early acute phase using plasma homocysteine as a biochemical marker. METHODS: Fasting plasma homocysteine, serum vitamin B12, and folate levels were measured in 108 consecutive unilateral elderly adult (age >50 years) ischemic CRVO patients in the absence of local and systemic disease and compared with a total of 144 age and sex matched nonischemic CRVO patients and 120 age and sex matched healthy control subjects. RESULTS: Homocysteine level was significantly increased in the patients with ischemic CRVO in comparison with nonischemic CRVO patients (p = 0.009) and also in comparison with control subjects (p 0.1). CONCLUSIONS: Hyperhomocysteinemia can be regarded as useful in differentiating nonischemic and ischemic CRVO during the early acute phase in absence of local and systemic disease in the elderly adult (age >50 years) population.

Vitreous hemorrhage and fibrovascular proliferation after laser-induced chorioretinal venous anastomosis / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To describe a case in which vitrectomy was required for vitreous hemorrhage and fibrovascular proliferation after laser-induced chorioretinal venous anastomosis (LCVA) for non-ischemic central retinal vein occlusion (CRVO).METHODS: Observational case report.RESULTS: A 72-year-old man complained of central scotoma in the left eye, and was diagnosed as suffering from non-ischemic CRVO. LCVA was performed in another hospital. Although favorable visual function was briefly maintained postoperatively,severe vitreous hemorrhage developed in his left eye, necessitating vitrectomy. CONCLUSION: Considering that LCVA carries a risk of serious complications, we must apply this treatment with caution, especially in ethnic groups, such as the Japanese, in whom pigmentation reacts to photocoagulation excessively.

Primary antiphospholipid syndrome associated with non-ischemic central retinal vein occlusion

Antiphospholipid syndrome is a disease producing vascular thrombosis with antiphospholipid antibody and usually associated with systemic lupus erythematosus. It is called primary antiphospholipid syndrome(PAPS) if it does not have the clinical features of collagen vascular disorder. Ocular manifestations of antiphospholipid syndrome include retinal vascular disorder, anterior ischemic optic neuropathy, and amaurosis fugax. Ocular manifestations are much less common in primary antiphospholiped syndrme than antiphospholipid syndrome associated with systemic lupus erythematosus. We experienced two cases of non-ischemic central retinal vein occlusion which were associated with primary anti phospholipid syndrome in two female patients, who complained sudden decrease of visual acuity in one eye. We report the cases with review of the literatures.