DR. PRAGATI TIWARI

DR. ABHISHEK

Abstract

Homocysteine plays an important role in the metabolism of folic acid and vitamin B12. Raised levels can predispose to atheromatous plaque in large and small vessels. This study aims to describe the clinical profile of vaso-occlusive retinal disorders in patients with homocysteinemia. It is a retrospective case series. The clinical characteristics of 6 patients with homocysteinemia and vascular occlusion are described. BRAO was present in 1, VH in 2, CRVO in 1, BRVO in 1 & combined vessel occlusion in 1. CBC, ESR, RBS, blood pressure, ANA, PT/INR, aPTT was normal. Elevated serum homocysteine was incidentally detected in all patients. Intravitreal anti-VEGF was given in 3 patients. 2 underwent vitrectomy. Laser was done in 1 eye. Vision improved in 4 eyes. One eye progressed to NVG despite aggressive therapy. Severe vaso-occlusive retinopathy can be the presenting manifestation of homocysteinemia. Early diagnosis and treatment can prevent fatal manifestations of stroke and MI.