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Farhan F. Malik, Atif Z. Mohiuddin, Lamise Z. Rajjoub, Jeevan Mathura; 25-OH Vitamin D Levels in Patients with Retinal Pathology: a Retrospective Study. Invest. Ophthalmol. Vis. Sci. 2011;52(14):3604.
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Vitamin D has received attention in the medical literature for its associations with cardiovascular disease and diabetes. We compare vitamin D levels in patients with diabetic retinopathy, age-related macular degeneration, retinal vascular occlusive disease and in patients without these conditions.
Retrospective review was performed of 565 patients with diagnoses of diabetic retinopathy (n=332), AMD (n=181) and retinal vascular occlusive disease (n=52) over the past 5 years with 25-OH vitamin D levels taken in the same time period. These patients were subcategorized by disease type and severity, and 25-OH vitamin D levels were compared with an age- and gender-matched control group (n=150) of patients seen in our ophthalmology department without the aforementioned diagnoses. In patients with multiple levels taken, the earliest level was used in an attempt to use levels taken before supplementation was initiated. Exclusion criteria included patients on 1000 IU or greater daily dose Vitamin D. Results were compared using student t-tests.
Mean serum 25-OH vitamin D levels (ng/dl) in the combined disease group, diabetic retinopathy group, AMD group, and retinal vascular occlusive disease group were 22.0, 19.0, 28.0 and 21.2 respectively. Mean serum 25-OH vitamin D level (ng/dl) in the control group was 25.3. The mean age in the combined group was 67.3 and 66.6% were female. Student t-tests revealed a significant difference between the control group compared to the combined disease group (p< 0.004), diabetic retinopathy group (p< 0.0001), and retinal vascular occlusive disease group (p< 0.035). When comparing patients with NPDR (n=246) and PDR (n=86), the mean levels were 19.2 ng/dl and 18.5 ng/dl, respectively (p<0.66). There was no difference (p<0.41) when comparing patients with dry AMD (n=156, mean level 28.3 ng/dl) to patients with wet AMD (n= 52, mean level 25.9 ng/dl).
Our retrospective study shows lower mean 25-OH vitamin D levels in patients with diabetic retinopathy and retinal vascular occlusion when compared to patients without retinal pathology. No difference in levels was observed when comparing patients with dry vs. wet AMD or NPDR vs. PDR. There was also no significant difference in levels of patients with AMD as a whole compared to patients without retinopathy. Further study is needed to identify whether vitamin D is a marker for the aforementioned conditions and if supplementation has any role in altering disease development or progress.
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