Publication: Manifestaciones retinianas secundarias a hiperhomocisteinemia en un caso de alcoholismo crónico
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Publication Date
2014-08
Authors
Palmero Fernández, Laura
Fernández Treguerres, Fernanda
Santos Bueso, Enrique
Sáenz Francés, Federico
Martínez de la Casa, Jose Maria
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Elsevier España
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Abstract
Caso clínico: paciente alcohólico con disminución de agudeza visual en el ojo derecho, presentando una hemorragia peripapilar temporal superior y, posteriormente, trombosis de subrama venosa. La analítica mostró hiperhomocisteinemia con coagulación normal. En la evolución desarrolló una neuropatía óptica bilateral.
Discusión: la elevación de homocisteína es común en alcohólicos, considerándose un factor de riesgo cardiovascular. El ácido fólico y las vitaminas B6 y B12 participan en el metabolismo y su déficit puede incrementar sus niveles.
Conclusiones: ante la observación de fenómenos vasculares oclusivos retinianos y neuropatía óptica isquémica en pacientes jóvenes, se deben descartar alteraciones en la coagulación y aumento de homocisteína.
Case report: An alcoholic patient with loss of vision in his right eye and a peripapillar haemorrhage, who then presented with a venous thrombosis. Blood analysis revealed hyperhomocysteinemia with coagulation parameters within the normal range. In the follow-up he developed a bilateral optic neuropathy. Discussion: An increase in homocysteine levels is common in alcoholics, and it has been considered a vascular risk factor. Folic acid and vitamins B6 and B12 deficiency may lead to hyperhomocysteinemia, as they participate in its metabolism. Conclusions: When presented with a retinal occlusive disease or ischemic optic neuropathy in young patients, coagulation disorders and elevated levels of homocysteine should be ruled out.
Case report: An alcoholic patient with loss of vision in his right eye and a peripapillar haemorrhage, who then presented with a venous thrombosis. Blood analysis revealed hyperhomocysteinemia with coagulation parameters within the normal range. In the follow-up he developed a bilateral optic neuropathy. Discussion: An increase in homocysteine levels is common in alcoholics, and it has been considered a vascular risk factor. Folic acid and vitamins B6 and B12 deficiency may lead to hyperhomocysteinemia, as they participate in its metabolism. Conclusions: When presented with a retinal occlusive disease or ischemic optic neuropathy in young patients, coagulation disorders and elevated levels of homocysteine should be ruled out.
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Received 28 January 2013, Accepted 08 July 2013