Purpose: To evaluate hyperhomocysteinemia hHcy as a cause of retinal vascular disease and neurophthalomogy in our hospital.

Materials and Methodology:

 It is a prospective study done between 2016 and 2018..This study includes 65 young patients,<50 yrs of age who presented in the ophthalmology department with retinal  vein occlusions(RVO) and nonarteritic optic neuropathy(NAION) and had no associated systemic or occular disease. In these study 45 patients had RVO and 20 patients were of NAION. All the patients were advised serum homocysteine levels.

Results: 22 patients with RVO and 6 pts of NAION, totaling to 28 came positive for high homocysteine levels and were started on vitamin B6 20 mg, B12 500 µg, folic acid 5 mg and glycine 500 mg along with other supportive treatment.  Among the positive patients, 60% (17 cases) had moderate, 32% (9 cases) of patients had intermediate, 2patients (8%) had severe hHcy. Treatment of these cases with vitamin supplementation showed a decrease in fasting serum homocysteine levels by 10 ± 4 µmol/L (range 6–15 µmol/L) after 6 months and resolution of the clinical findings

Conclusion: In all cases of veno– occlusive disorders and NAION, evaluation of homocysteine levels plays an important role. hHcy treated with vitamin B12 and folic acid shows a decrease in the risk of complications. All detected cases of hHcy should undergo an ophthalmic evaluation at the earliest