title: Is retinal assessment useful in epileptic patients with hyperhomocysteinemia?
abstract: OBJECTIVE
  The arteriole-to-venule ratio (AVR) is widely used for investigating subclinical cerebral microangiopathy. The possible occurrence of retinal vascular caliber changes was investigated in a population of hyperhomocysteinaemic (plasma total homocysteine (tHcy) >13 micromol/l) adult epileptic patients.
  
  
  METHODS
  Retinal photographs of cases and controls were evaluated for generalized narrowing of the retinal arterioles, measured as AVR, by graders masked to case-control status using standardized protocols. Plasma total homocysteine (tHcy) levels were assayed by HPLC.
  
  
  RESULTS
  Sixty-seven patients (36M/31F, 36.4+/-7.5 years of age; mean level of tHcy 22.8+/-11.4 micromol/l), and 75 control subjects (42M/33F, 35.4+/-8.5 years of age; mean level of tHcy 7.8+/-2.3 micromol/l) were enroled. No retinal caliber changes were detected in any patient and healthy subject. The analysis of retinal photographs failed to identify any difference in the venular diameters, arteriolar diameters, and AVR measurements between the two groups (P=0.98).
  
  
  CONCLUSIONS
  We showed that adult hyperhomocysteinaemic epileptic patients do not show any changes in retinal vascular caliber assessed by the measurement of AVR.
authors.affiliation: Neurology Clinic, University of Perugia, Italy. vincenzobelcastro@libero.it
authors.forename: V
authors.initials: V
authors.lastname: Belcastro
authors.forename: P
authors.initials: P
authors.lastname: Striano
authors.forename: C
authors.initials: C
authors.lastname: Ciampa
authors.forename: L
authors.initials: L
authors.lastname: Pierguidi
authors.forename: M
authors.initials: M
authors.lastname: Napoli
authors.forename: M C
authors.initials: MC
authors.lastname: Freno
authors.forename: R
authors.initials: R
authors.lastname: Tenore
authors.forename: S
authors.initials: S
authors.lastname: Striano
authors.forename: F
authors.initials: F
authors.lastname: Pisani
authors.forename: C J
authors.initials: CJ
authors.lastname: Trombetta
mesh_terms: D000328:Adult; D001160:Arterioles / Q000473:pathology; D004827:Epilepsy / Q000150:complications*; D005260:Female; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012160:Retina / Q000473:pathology; D012171:Retinal Vessels / Q000473:pathology*; D014699:Venules / Q000473:pathology