E u ropean Journal of Ophthalmology / Vol. 16 no. 4, 2006 / pp. 5 4 2- 5 4 7 1 1 2 0 - 6 7 2 1 /5 4 2- 0 6 $ 1 5 . 0 0 / 0 © Wichtig Editore, 2006 Homocysteine levels in plasma and sensorineural hearing loss in patients with pseudoexfoliation syndro m e B. AY D OG ˇ AN OZKAN 1 , N. YÜKSEL 1 , G. KESKIN 2 , Ö. ALT I N TAS ¸ 1 , V.L. KARABAS ¸ 1 , Y. ÇAG ˇ L A R 1 , A. ALMAÇ 2 1 Department of Ophthalmology 2 Deparment of ENT, Kocaeli University, Kocaeli - Tu r k e y INTRODUCTION Pseudoexfoliation syndrome (PXS) is an age-related disease in which abnormal fibrillar extracellular material is progressively produced and accumulated in ocular tis- sues (1-3). Pseudoexfoliation fibers have been discovered in many visceral organs such as heart, lung, liver, gall bladder, kidney, and cerebral meninges (4-6). There is in- creasing evidence for systemic manifestations of PXS. The most mentioned manifestations are vascular diseases including history of angina, hypertension, or stroke and abdominal aortic aneurysms (7-10). PXS is more common PU R P O S E. To determine the incidence and severity of hearing loss in different fre q u e n c i e s in patients with pseudoexfoliation. Furtherm o re, possible links between homocysteine and pseudoexfoliation were evaluated. METHODS. Seventy-five consecutive patients with pseudoexfoliation and 75 sex- and age-matched subjects without pseudoexfoliation as control group were included in this prospective case- control study. Pure-tone audiometry was obtained in all subjects in both groups. Blood sam- ples were obtained from 70 patients with pseudoexfoliation after overnight fasting for levels of homocysteine and analyzed by routine laboratory measure m e n t s . RESULTS. Fifty-two (69%) patients with pseudoexfoliation and 39 (52%) controls had sensorineural hearing loss in speech frequencies. The difference between pseudoexfoliation and control group with regard to the frequency of sensorineural hearing loss in speech frequencies was statistically significant (p=0.03). No relationship was found between the degree of glauco- matous damage and hearing threshold variables in the patients with pseudoexfoliation glau- coma. Plasma homocysteine levels showed no significant difference when patients with pseu- doexfoliation and hearing loss were compared with patients with pseudoexfoliation and nor- mal hearing threshold (p=0.5). Hyperhomocysteinemia was found in 58% (29/50) of pseu- doexfoliation patients with hearing loss, and 55 % (11/20) of pseudoexfoliation patients with n o rmal hearing threshold (p=0.8). No statistically significant correlation was found between plasma homocysteine and hearing loss in patients with pseudoexfoliation. CO N C L U S I O N S. These findings suggest an association between sensorineural hearing loss and pseudoexfoliation in patients with pseudoexfoliation and glaucoma. The severity of hearing loss was not correlated with the degree of glaucomatous damage. There is no association between increased homocysteine levels and hearing loss in patients with pseudoexfoliation. (Eur J Ophthalmol 2006; 16: 5 4 2- 7 ) KE Y WO R D S. A u d i o m e t ry, Glaucoma, Hearing loss, Homocysteine, Pseudoexfoliation Accepted: February 7, 2006