title: Central retinal artery occlusion in a 13-year-old child as a presenting sign of hyperhomocysteinemia together with high lipoprotein(a) level.
abstract: BACKGROUND
  We describe a child with central retinal artery occlusion and hyperhomocysteinemia.
  
  
  METHODS
  A 13-year-old girl developed sudden vision loss and was hospitalized for diagnosis and treatment.
  
  
  RESULTS
  Her physical examination was normal except for her ophthalmologic examination. Her serum homocysteine level and lipoprotein(a) were elevated to 45.27 μmol/L and 61 mg/dL 0-29 mg/dL, respectively. A homozygous mutation was identified for methylenetetrahydrofolate reductase at position C677T.
  
  
  CONCLUSIONS
  This report documents central retinal artery occlusion associated with the risk factors of hyperhomocysteinemia caused by methylenetetrahydrofolate reductase C677 T mutation and high lipoprotein(a) level in a child. Retinal artery occlusion is rare in children. This patient emphasizes the need for a systemic evaluation for hyperhomocysteinemia and lipoprotein(a) levels in children with retinal vascular occlusion of uncertain etiology.
authors.affiliation: Department of Ophthalmology, Baskent University Faculty of Medicine, Ankara, Turkey. bkaratas99@hotmail.com
authors.forename: M
authors.initials: M
authors.lastname: Coban-Karatas
authors.forename: Ilknur
authors.initials: I
authors.lastname: Erol
authors.forename: Yasemin
authors.initials: Y
authors.lastname: Ozkale
authors.forename: Nalan
authors.initials: N
authors.lastname: Yazıcı
mesh_terms: D000293:Adolescent; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood* / Q000150:complications* / Q000235:genetics; D017270:Lipoprotein(a) / Q000097:blood*; D042965:Methylenetetrahydrofolate Reductase (NADPH2) / Q000235:genetics; D009154:Mutation / Q000235:genetics; D010211:Papilledema / Q000473:pathology; D015356:Retinal Artery Occlusion / Q000097:blood* / Q000209:etiology* / Q000235:genetics; D041623:Tomography, Optical Coherence
chemical_list: D017270:Lipoprotein(a); D042965:Methylenetetrahydrofolate Reductase (NADPH2)