Prevalence of homocysteinemia and effect of vitamin supplementation in retinal vein occlusion

OBJECTIVE: The objective of this study was to determine the prevalence of homocysteinemia in patients with retinal vein occlusion (RVO). We investigated the association of B complex vitamin (BCV) and multivitamin (MVI) supplementation on homocysteine levels in RVO patients. METHODS AND ANALYSIS: This cross-sectional study occurred at the Retina Center of New Jersey. We investigated 312 patients diagnosed with RVO between 2011 and 2019. Homocysteine levels were measured on diagnosis of RVO and 4–8 weeks after, following recommended daily supplementation with BCV, MVI or combination MVI+BCV. RESULTS: The median patient age was 71.00, IQR (61.00, 78.25), with 164 (52.6%) being women. Prevalence of homocysteinemia (>13 µmol/L) was 150 of 312 (48.1%), with a median baseline homocysteine level of 12.80 (10.17, 15.90) µmol/L. The follow-up cohort, 105 patients, demonstrated significant reduction in median homocysteine levels from 14.50 (12.30, 17.90) to 10.70 (9.30, 13.50) µmol/L following vitamin supplementation. Multivariate analysis found having baseline homocysteinemia was significantly associated with at least 25% reduction in homocysteine following vitamin supplementation. CONCLUSIONS: In this study, 48.1% of patients with RVO had elevated homocysteine (>13 µmol/L). Supplementation with BCV or MVI+BCV was associated with a significant reduction in homocysteine from 14.50 (12.30, 17.90) to 10.70 (9.30, 13.50) µmol/L.