There is still no agreement on total plasma homocysteine (tHcy) role in age-related macular degeneration (AMD), the leading cause of new blindness in industrialized countries. We performed a systematic review and meta-analysis of the published data on the correlation between tHcy and AMD. MEDLINE/PubMed and ISI Web of Sciences searches were performed according to MOOSE guidelines. Case-control studies were eligible for inclusion. Participants and controls were AMD patients and subjects without AMD. The main outcome measure was wet AMD. Homocysteine level was the main exposure variable. Data were pooled using a random-effects model. Twelve case-control studies were identified: 10 assessed wet AMD, four dry AMD, one early AMD, one late AMD, and one any AMD. As for wet AMD, there was a total of 453 cases and 514 controls. Mean tHcy was on average 1.1 μmol/l (95% confidence interval [CI] = 0.96-1.25) greater in wet AMD cases, but there was evidence of extreme between-study heterogeneity (p < 0.001, I = 91.8%). In a model homogenous for age, including six wet AMD studies (214 cases, 274 controls), mean tHcy was on average 0.58 μmol/l (95% CI = 0.35-0.73) greater in the case group, a not statistically significant result (p = 0.144) associated with moderate heterogeneity (I = 39.2%). Our meta-analysis indicates that there is some weak evidence that increased tHcy might be associated with wet AMD; however, this result should be interpreted cautiously, because of a marked between-study heterogeneity and the possible effect of publication bias. Future studies, preferably of cohort design, are necessary before any firm conclusions on the putative role of increased tHcy on AMD can be drawn.

Melanoma arising in a burn scar is very uncommon. We report a recent case of a female patient in whom two different melanomas arose on a wide back burn scar at different times, focusing attention on three different potential risk factors for melanoma the patient had: sunburns, laser therapy on back and burn scar.

PurposeWet age‐related macular degeneration (AMD) is an important cause of vision loss. We performed a meta‐analysis review of the literature to assess the role of plasma total homocysteine (tHcy) concentration a as risk factor for wet AMD.MethodsData sources included PubMed searches and searching reference lists of relevant articles and reviews. The literature review was performed according to the guidelines of Meta‐analysis of Observational Studies in Epidemiology (MOOSE). Case‐control studies were eligible for inclusion. Meta‐analysis summary estimates were obtained using a random‐effects model to account for between‐study heterogeneity.Results9 case‐control studies were identified, for a total of 422 cases and 467 controls. The mean tHcy was on average 1.18 μmol/L (95% confidence interval [CI] = 1.03–1.33) greater in the wet AMD cases compared with the controls (P < 0.001), but patients’ and controls’ ages showed a high degree of between‐study heterogeneity. After exclusion of the two studies with higher age heterogeneity, there were 243 cases and 277 controls and the mean tHcy was on average 0.7 μmol/L (95% CI = 0.52–0.88) greater in the wet AMD patients compared to the controls (P = 0.03).ConclusionsThere is some weak evidence that elevated tHcy might be associated with wet AMD; however, this result should be interpreted cautiously because of a marked heterogeneity between the study estimates and the possible effect of publication bias on the tHcy findings.