Homocysteinemia as a cause for amaurosis fugax in a patient without an apparent embolic source

Rom J Ophthalmol. 2019 Apr-Jun;63(2):188-192.

Abstract

Purpose: To report a case with monocular transient vision loss (TVL) associated with Hyperhomocysteinemia. Methods: We present a case with persistent TVL attacks and high level of homocysteine. Results: A 32-year-old male had a history of episodes of recurrent monocular TVL. Extensive ophthalmic, systemic and laboratory studies were unremarkable with the exception of high plasma homocysteine level. He never experienced TVL during the 36-month follow-up after starting folate, B12 and B6 except for one episode in which he had discontinued the treatment for three months. Conclusion: This case may suggest hyperhomocysteinemia as one of the underlying causes of recurrent attacks of TVL without any known source of emboli.

Keywords: Transient Visual Loss; homocysteinemia; recurrent attacks.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Amaurosis Fugax / diagnosis
  • Amaurosis Fugax / etiology*
  • Amaurosis Fugax / physiopathology
  • Biomarkers / blood
  • Brain / pathology*
  • Homocysteine / blood*
  • Humans
  • Hyperhomocysteinemia / blood
  • Hyperhomocysteinemia / complications*
  • Hyperhomocysteinemia / diagnosis
  • Intracranial Embolism
  • Magnetic Resonance Imaging
  • Male
  • Ophthalmic Artery / diagnostic imaging
  • Recurrence
  • Ultrasonography, Doppler, Color
  • Visual Acuity*

Substances

  • Biomarkers
  • Homocysteine

Supplementary concepts

  • Homocysteinemia