Association of Serum Homocysteine Levels with Hypertensive Retinopathy: A Tertiary-Care Cross-Sectional Study
Bharti Nigam, Zaman Beg, Luxmi Singh, Gaurav Kohli, Irshad AhmadAbstract
Background:
Hypertensive retinopathy reflects retinal microvascular damage in patients with systemic hypertension. Homocysteine has been linked with endothelial dysfunction, oxidative stress, and prothrombotic vascular injury, but clinical evidence relating it to hypertensive retinopathy remains limited.
Aim:
To evaluate the association between serum homocysteine levels and hypertensive retinopathy and to compare homocysteine levels across grades of retinopathy.
Materials and Methods:
This cross-sectional study included 108 hypertensive patients attending the ophthalmology department of a tertiary care teaching hospital in North India. Fifty-four patients had hypertensive retinopathy and 54 had hypertension without retinopathy. Patients with vitamin supplementation, medications or systemic disorders known to affect homocysteine levels, other retinopathies, ocular trauma, previous ocular surgery or laser treatment were excluded. All participants underwent systemic and ocular evaluation, including blood pressure measurement, visual acuity assessment, intraocular pressure measurement, and dilated fundus examination. Blood samples were collected in red-top tubes, and serum homocysteine was measured by chemiluminescent immunoassay. Data were analysed using Chi-square test, Student’s
Results:
Patients with retinopathy were older and had longer recorded duration of hypertension and higher systolic, diastolic and mean arterial pressure than those without retinopathy. Mean serum homocysteine was significantly higher in patients with hypertensive retinopathy than in those without retinopathy (21.57 ± 7.18 vs 10.95 ± 2.41 micromol/L;
Conclusion:
Serum homocysteine was associated with the presence and severity of hypertensive retinopathy in this cross-sectional sample. Because the study was observational and the adjusted estimate had a wide confidence interval, these findings should be interpreted as an association that warrants further evaluation rather than evidence of diagnostic performance, causality or therapeutic benefit.