Association between vitamin D and age-related macular degeneration: the Alienor study

Abstract

Purpose: Owing to the potential role of inflammation in AMD development and progression, it has been suggested that vitamin D may protect against the occurrence and progression of AMD thanks to its anti-inflammatory properties. The objective of this study was to examine the association between serum vitamin D levels and prevalent age-related macular degeneration (AMD).

Methods: The Alienor study is a population-based study on age-related eye diseases performed in 2006-2008, in 963 elderly (≥73 years) residents of Bordeaux (France). AMD was graded from non mydriatic color retinal photographs in three exclusive stages: no AMD (n=523 subjects with complete data, 1036 eyes); large soft distinct drusen and/or large soft indistinct drusen and/or reticular drusen and/or pigmentary abnormalities (early AMD, n=223, 281 eyes); late AMD (n=47, 65 eyes). Serum vitamin D (25-hydroxyvitamin D) levels were assessed from blood samples collected in 1999-2001 and stored at -80°C. Vitamin D levels were categorized as < 10 ng/mL (severe deficiency), 10 to 20 ng/mL (moderate deficiency), or ≥ 20 ng/mL (no or mild deficiency). Associations between AMD and vitamin D levels were estimated using Generalized Estimating Equation logistic regressions.

Results: The prevalence of severe, moderate and no or mild vitamin D deficiencies among participants were 28.4%, 54.6% and 17.0% respectively. Vitamin D deficiency was more prevalent among women (p=0.0002) and in subjects older than 80 years (p=0.02). Means of vitamin D in spring, summer, autumn and winter were 13.4 ng/mL, 15.9 ng/mL, 15.8 ng/mL and 13.5 ng/mL respectively (p<0.0001). After multivariate adjustment for age, sex and season, no significant associations were found between early AMD and moderate or severe deficiency in vitamin D (OR=0.75, 95% CI: 0.50-1.13; OR=0.72, 95% CI: 0.45-1.18 respectively); between late AMD and moderate or severe deficiency in vitamin D (OR=1.23, 95% CI: 0.48-3.16; OR=0.89, 95% CI: 0.30-2.59 respectively); and between any AMD and moderate or severe deficiency in vitamin D (OR=0.81, 95% CI: 0.54-1.20; OR=0.76, 95% CI: 0.47-1.21 respectively).

Conclusions: We did not find any significant associations between vitamin D deficiency and early, late or any AMD. These findings do not support a specific role for vitamin D in AMD but underline the high prevalence of severe vitamin D deficiency in this elderly population.

Keywords: 412 age-related macular degeneration