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Vitamin B12 levels in patients with retinal vein occlusion and their relation with clinical outcome: a retrospective study

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Abstract

Retinal vein occlusion (RVO) is the second most common retinal vascular disorder, after diabetic retinopathy. Most patients suffering RVO develop some degree of visual loss consequent to retinal complications such as edema and microhemorrhages. Even if some risk factors for RVO have been identified, the clinical outcome of RVO remains highly unpredictable because studies investigating potential prognostic markers for visual improvement are lacking. Cyanocobalamin belongs to the group of B vitamins and plays a role in homocysteine metabolism; however, cyanocobalamin deficiency associates with an increase of some toxic bioproducts involved in endothelial injury and platelet activation independent of homocysteine levels. We retrospectively evaluated the levels of vitamin B12 at diagnosis in 203 patients with RVO, and in a parallel cohort of 120 age- and sex-matched patients without RVO from an internal medicine ward, and correlated them with visual outcome at follow-up (median time 150 days, IQR 30–210). In patients with RVO, vitamin B12 levels at diagnosis were significantly lower than in controls and independently predicted worse clinical outcome at multivariate analysis (OR 3.2; CIs 1.2–8.2; p = 0.015). Our data suggest the opportunity to prospectively evaluate the effect on visual outcome of cyanocobalamin supplementation in RVO patients.

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Authors and Affiliations

  1. Division of Internal and Cardiovascular Medicine, Department of Medicine and Surgery, University of Perugia, Strada Vicinale Via delle Corse, 06126, Perugia, Italy

    Francesco Paciullo & Paolo Gresele

  2. Division of Ophthalmology, Department of Medicine and Surgery, University of Perugia, Perugia, Italy

    Paola Santina Menduno, Davide Tucci, Anna Caricato & Carlo Cagini

  3. Ospedale di Assisi, via Valentin Muller 1, Assisi, Perugia, Italy

    Francesco Paciullo

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  1. Francesco Paciullo
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  2. Paola Santina Menduno
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  3. Davide Tucci
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  4. Anna Caricato
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  5. Carlo Cagini
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  6. Paolo Gresele
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Correspondence to Francesco Paciullo.

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The study protocol was conducted in accordance with the Declaration of Helsinki.

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This article does not contain any studies with animals performed by any of the authors. Patients data were anonymized and analyzed in aggregate form.

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Informed consent for the utilization of clinical data for scientific aims was acquired at the time of hospital admission.

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Paciullo, F., Menduno, P.S., Tucci, D. et al. Vitamin B12 levels in patients with retinal vein occlusion and their relation with clinical outcome: a retrospective study. Intern Emerg Med 17, 1065–1071 (2022). https://doi.org/10.1007/s11739-021-02905-7

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