Retinal Vascular Occlusive Disease and The Role of Homocysteine

What is "Retinal Vascular Occlusive Disease"?

There are several different varieties of this condition, which are:

Retinal Vein Occlusions

• Central Retinal Vein Occlusion
• Branch Retinal Vein Occlusion

and...

Retinal Artery Occlusions

• Central Retinal Artery Occlusion
• Branch Retinal Artery Occlusion

With this disease, a blockage of a retinal blood vessel produces a situation in the eye that is similar to a stroke in the brain. The symptoms usually include a sudden, painless loss of vision, nearly always in one eye only.

The retina of this glaucoma suspect shows an extensive network of arteries and vein that supply the high demand of the nerves for blood.

These specific conditions are discussed in more detail below.

Risk Factors for Retinal Vascular Occlusive Disease

As you might expect, blockage of a retinal vessel is more common in patients with carotid artery disease, heart disease and other circulatory diseases like diabetes.

This is simply one more reason to maintain a good, healthy diet (See Nutritional Principles), don't smoke, exercise and follow your doctor's advice on your retinal vascular occlusive disease.

The Role of Homocysteine...

Several published studies have shown that an elevated level of an amino acid called homocysteine is a risk factor for retinal vessel occlusion.

Homocysteine is a toxic byproduct that has been shown to damage blood vessels.

• Homocysteine is an intermediate product of the normal metabolism of the amino acid methionine to cysteine. Cysteine is then usually recycled by enzymes back into methionine. This enzyme reaction is dependent on a good supply of folic acid, vitamin B-12 and vitamin B-6.
• An alternative pathway uses methyl groups (methylamine) to eliminate homocysteine.
• Elevated homocysteine levels have also been shown in studies to increase risk of coronary disease, though there is some controversy about these findings.

Monitoring and Controlling Homocysteine Levels

Some retinal specialists will monitor homocysteine in all retinal vascular occlusions as well as in diabetics. Other don't.

Nutritionally-oriented primary care physicians usually monitor homocysteine as a coronary disease risk.

Many standard medical laboratories consider a blood level of homocysteine below 10.0 to be normal. However, many studies indicate that a level above 7.5 demonstrates an elevated risk.

If you have had a retinal vascular occlusive event, take 1mg of both folic acid and vitamin B-12 daily.

In addition take at least 75-100mg of vitamin B-6.

Have your doctor check your homocysteine level. It's a simple blood test.

If the above supplements don't lower it into a safe range, order a supplement called trimethylglycine (TMG). You can get it online at lef.org or vitacost.com. Take 3000 to 5000 mg per day.

Make sure you have a physician who will talk to you about this.

Summary

Retinal vascular occlusion is basically a stroke of the retina, and like a stroke of the brain there simply isn't much that can be done.

Control your homocysteine to try to make sure it doesn't happen to the other eye.

There are several problems that can develop from these occurrences, like neovascular glaucoma, so it's extremely important to follow-up closely with your eye doctor for months afterwards.

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