Serum vitamin D levels in Indian patients with retinal venous occlusions

Serum vitamin D level alterations in retinal vascular occlusions

AIM

To evaluate serum vitamin D levels in sub-types of retinal vascular occlusions and compare the levels in ischemic and non-ischemic presentations.

METHODS

This study included 50 patients of retinal vascular occlusions comprising central retinal vein occlusion, branch retinal vein occlusion, central retinal artery occlusion, branch retinal artery occlusion (study group) diagnosed on basis of clinical characteristics as well as investigations and an age and gender-matched healthy control group (control group). The study group was further classified into ischemic and non-ischemic subtypes and serum vitamin D levels were analysed and compared.

RESULTS

There were 50 patients of various sub-types of retinal vascular occlusions comprising 13 cases of CRVO, 30 cases of BRVO, 05 cases of CRAO, 02 cases of BRAO and 50 age and sex-matched controls. Mean BCVA and CMT in RVO patients was +1.12 log MAR, 346.72 ± 27.93 µm while in control group was +0.37 log MAR, 236.22 ± 3.71 µm which were statistically significant (p = 0.004; p = 0.002). The mean serum vitamin D value in study group was 18.39 ng/dl as compared to 32.31 ng/dl in control group which was statistically significant (p = 0.001). The difference in the baseline vitamin D value between the ischemic and non -ischemic sub groups among total vascular occlusion was found to be statistically significant (p = 0.010). However, baseline vitamin D levels difference among ischemic and non-ischemic cases in individual sub-types of vascular occlusion was statistically insignificant.

CONCLUSION

High prevalence of low serum vitamin D levels is seen in patients of retinal vascular occlusion spectrum diseases. Moreover, ischemic types of retinal vascular occlusion have significantly lower serum vitamin D levels as compared to non - ischemic despite having fewer no of patients in arterial occlusion sub-types. Therefore, vitamin D supplements may be considered as possible future targeted therapy in optimizing the severity of disease.

Prevention and Treatment of Retinal Vein Occlusion: The Role of Diet-A Review

Retinal vein occlusion (RVO) is the second most common retinal disorder. In comparison to diabetic retinopathy or age-related macular degeneration, RVO is usually an unexpected event that carries a greater psychological impact. There is strong evidence to suggest that cardiovascular diseases are the most common risk factors in this pathology and it has long been known that a higher consumption of fish, nuts, fruits, and vegetables has a protective effect against these types of conditions. In the last several years, interest in plant-based diets has grown in both the general population and in the scientific community, to the point to which it has become one of the main dietary patterns adopted in Western countries. The aim of this review is to investigate the potential impact of macro- and micronutrients on retinal vein occlusion.

Estimation of Vitamin D Levels in Patients With Retinal Vein Occlusions and a Comparison With Age-Matched Control Groups

Background In the older population, retinal vein occlusion (RVO) is a major contributor to vision loss and blindness. RVO is the second most common form of retinal vascular disease, following diabetic retinopathy. On the other hand, there is a paucity of studies on vitamin D insufficiency and its influence on the causation of RVOs. The goal of this study is to demonstrate a link between vitamin D levels of individuals in rural India who have RVOs. Methods This study is a hospital-based prospective case-control study. All patients aged 18 years and above with RVO visiting the ophthalmology outpatient department at a tertiary care facility in central India and all controls in the same age group were chosen for the study after taking into consideration inclusion and exclusion criteria. Fasting for 12 hours prior to blood sample collection was required of all participants. The total vitamin D concentration in the serum was determined using tandem mass spectrometry after it had been frozen at 20°C. For this study, vitamin D levels were collected from 70 participants. Results The average age is 60, with a standard variation of 10 for both cases and controls. There is a 49% prevalence of central RVO (CRVO), 34% prevalence of inferotemporal branched RVO (IT BRVO), and 17% prevalence of superotemporal BRVO (ST BRVO). Twenty percent of the 35 patients were deficient in vitamin D, and 80% had insufficient levels. No case patient had vitamin D levels within the normal range. No one with vitamin D insufficiency was found among the 35 controls. Twenty-five percent of the patients had adequate vitamin D levels, but only 28.6% of the controls did. The p-value of 0.01 indicates a remarkable difference in vitamin D levels between the diagnosed cases and controls. Cases had mean vitamin D levels of 21.408 +/- 4.947 ng/dl, while controls had mean levels of 37.808 +/- 11.799 ng/dl. Vitamin D levels did not differ significantly across RVO subtypes. The study also shows the association of RVO with hypertension (HTN) and dyslipidemia as the p-value was noted to be significant (p = 0.0147 < p = 0.05) for HTN with an odds ratio of 3.43 (CI, 1.25-9.4) and was significant (p = 0.0404 < p = 0.05) for dyslipidemia with an odds ratio of 4.87 (CI, 0.96-24.97). Diabetes, smoking, hyperhomocysteinemia, dyslipidemia, cardiovascular disease, and cerebrovascular accident are all well-known risk factors, but we found no evidence associating them together. Conclusion  Vitamin D proved to be an important risk factor in the causation of RVOs. Other risk factors like HTN and dyslipidemia also showed significant relation in the study. Vitamin D levels should be advised as a routine investigation in patients who are diagnosed with RVOs along with screening for other risk factors. Vitamin D supplementation should be given as prophylaxis in cases of deficiency.

Vitamin D, the Vitamin D Receptor, Calcitriol Analogues and Their Link with Ocular Diseases

The global prevalence of eye diseases continues to grow, bringing with it a reduction in the activity levels and quality of life of patients, and partial or complete blindness if left untreated. As such, there is considerable interest in identifying more effective therapeutic options and preventive agents. One such agent is vitamin D, known to have a range of anti-cancer, anti-angiogenic, anti-inflammatory and anti-oxidative properties, and whose deficiency is linked to the pathogenesis of a range of cardiovascular, cancer, and inflammatory diseases. This review presents the current stage of knowledge concerning the link between vitamin D and its receptor and the occurrence of eye disease, as well as the influence of analogues of calcitriol, an active metabolite of vitamin D. Generally, patients affected by various ocular disorders have vitamin D deficiency. In addition, previous findings suggest that vitamin D modulates the course of eye diseases and may serve as a marker, and that its supplementation could mitigate some disorders. However, as these studies have some limitations, we recommend further randomized trials to clarify the link between vitamin D and its activity with eye disease.

Vitamin D and Ocular Diseases: A Systematic Review

The contributory roles of vitamin D in ocular and visual health have long been discussed, with numerous studies pointing to the adverse effects of vitamin D deficiency. In this paper, we provide a systematic review of recent findings on the association between vitamin D and different ocular diseases, including myopia, age-related macular degeneration (AMD), glaucoma, diabetic retinopathy (DR), dry eye syndrome (DES), thyroid eye disease (TED), uveitis, retinoblastoma (RB), cataract, and others, from epidemiological, clinical and basic studies, and briefly discuss vitamin D metabolism in the eye. We searched two research databases for articles examining the association between vitamin D deficiency and different ocular diseases. One hundred and sixty-two studies were found. There is evidence on the association between vitamin D and myopia, AMD, DR, and DES. Overall, 17 out of 27 studies reported an association between vitamin D and AMD, while 48 out of 54 studies reported that vitamin D was associated with DR, and 25 out of 27 studies reported an association between vitamin D and DES. However, the available evidence for the association with other ocular diseases, such as glaucoma, TED, and RB, remains limited.