Homocysteine in tear fluid of patients with pseudoexfoliation glaucoma.

PURPOSE: To evaluate homocysteine (Hcy) concentrations in tear fluid and plasma and their association with B-vitamin levels in patients with pseudoexfoliation glaucoma (PEXG).

PATIENTS AND METHODS: Reflex tear and blood samples were obtained in 30 patients with PEXG and 30 controls. Hcy levels were determined by high-performance liquid chromatography.

RESULTS: Hcy was detected in all tear fluid samples of patients with PEXG and controls. Statistical analysis with t tests showed that patients with PEXG had significantly higher Hcy levels both in tear fluid (237+/-133 nmol/L vs. 128+/-54 nmol/L; P<0.001) and in plasma (14.51+/-4.43 micromol/L vs. 10.22+/-2.77 micromol/L; P<0.001) than control subjects. Hcy in tear fluid correlated significantly with Hcy in plasma (r=0.438, P=0.015) and with serum B12 levels (r=-0.424, P=0.019) in patients with PEXG, but not in controls.

CONCLUSIONS: The study suggests increased Hcy levels in tear fluid and plasma of patients with PEXG. Further investigations are needed to evaluate the possible clinical role of Hcy in ocular surface and systemic disorders associated with PEXG.