A Review of Homocysteine as a Diagnostic Tool for Diabetic Retinopathy

The aim of this systematic review is to identify plasma homocysteine (Hcy) as a screening and diagnostic indicator for assessing diabetic retinopathy (DR) risk in patients with type 2 diabetes mellitus. Following PRISMA guidelines, data was gathered from publications between 2000−2019 from the Springer, JAMA, Lancet, and PubMed databases, as well as from diabetes-specific journals. Observational, experimental, and multi-ethnic studies, meta-analyses, systematic reviews were included and studies that did not measure plasma Hcy, or included only patients with type 1 diabetes were excluded. The collected results were pooled and analysed for this systematic review. The majority of studies suggested an affirmative relationship exists between hyperhomocysteinemia (HHcy) and DR, whereas some studies showed only limited clinical significance. HHcy is considered a pivotal risk factor for macular edema progression in patients with DR. Serum Hcy levels could be used to assess microvascular risksforthe development and progression of DR.