Graefe’ s Arch Clin Exp Ophthalmol (2005) 243: 677–683 DOI 10.1007/s00417-004-1097-2 CLINICAL INVESTIGATION Özgül Altintaş Hale Maral Nurşen Yüksel V. Levent Karabaş Meltem Ö. Dillioğlugil Yusuf Çağlar Received: 27 August 2004 Revised: 12 November 2004 Accepted: 19 November 2004 Published online: 2 February 2005 # Springer-Verlag 2005 Homocysteine and nitric oxide levels in plasma of patients with pseudoexfoliation syndrome, pseudoexfoliation glaucoma, and primary open-angle glaucoma Abstract Purpose: To evaluate plasma total homocysteine (tHcy) and nitric oxide (NO) marker levels in patients with pseudoexfoliation syn- drome (PXS), pseudoexfoliation glaucoma (PXG), primary open-angle glaucoma (POAG), and normal con- trols. Methods: This cross-sectional, prospective study involved 19 pa- tients with POAG, 18 with PXS, 22 with PXG, and 20 control subjects. Fasting tHcy levels of all study participants were determined using a fluorescence polarization immuno- assay method. Quantitation of total nitrate was based on the Griess reac- tion, in which a chromophore with a strong absorbance at 545 nm is formed by reaction of nitrite with a mixture of naphthylethylenediamine and sulphanilamide. Results: The mean plasma homocysteine level was statistically significantly elevated in the PXS (p=0.033) and the PXG (p=0.023) groups but not in the POAG group (p=0.996) when com- pared with the control group. Multiple logistic regression analyses compar- ing the various patient groups with the single control group indicated that elevation in plasma homocysteine concentration was a significant risk factor for PXS (odds ratio per 1 μmol/l increase in homocysteine concentra- tion=2.05, 95% CI=1.19–3.52) and PXG (odds ratio per 1 μmol/l increase in homocysteine concentration=1.36, 95% CI=1.00–1.85) but was not a significant risk factor for POAG (odds ratio per 1 μmol/l increase in homo- cysteine concentration=0.99, 95% CI=0.78–1.26). NO markers levels were found to be slightly higher in PXS and PXG patients than control and POAG patients but the differ- ences were not statistically significant (p=0.151). Multiple logistic regres- sion analyses comparing the various patient groups with the single control group indicated that elevation in NO marker concentration was not a sig- nificant risk factor for PXS (odds ratio per 1 μmol/l increase in NO concen- tration=1.00, 95% CI=0.99–1.01), PXG (odds ratio per 1 μmol/l increase in NO concentration=1.00, 95% CI=0.99–1.00) and POAG (odds ratio per 1 μmol/l increase in NO concen- tration=0.99, 95% CI=0.99–1.00). No statistically significant correlations were observed between plasma tHcy and NO markers in study groups (p>0.05). Conclusion: Elevated lev- els of homocysteine in pseudoexfo- liation patients with and without glaucoma may partly explain the increased risk of vascular disease among patients with pseudoexfolia- tion. No significant difference was found in plasma NO markers among the POAG, PXS, PXG, and the con- trol subjects. Ö. Altintaş . N. Yüksel . V. L. Karabaş . Y. Çağlar Department of Ophthalmology, School of Medicine, Kocaeli University, Kocaeli, Turkey H. Maral . M. Ö. Dillioğlugil Department of Biochemistry, School of Medicine, Kocaeli University, Kocaeli, Turkey Ö. Altintaş (*) 60 evler, Yavuz Sultan mah., Rıhtım cad., Sahil Konak., M blk., K:3, D:12, Derince, 41900 Kocaeli, Turkey e-mail: ozgulaltintas@yahoo.com Tel.: +90-532-6166123 Fax: +90-262-2335488