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Sujit Itty, Lejla Vajzovic, Shelley Day, Prithvi Mruthyunjaya; Vitamin D Insufficiency in Neovascular versus Non-neovacular Age Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5182.
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Vitamin D insufficiency is an under-recognized condition in the elderly population who also are also at risk for developing macular degeneration. In this study, we compare vitamin D levels and the prevalence of vitamin D insufficiency in patients with neovascular (NVAMD) and non-neovascular age related macular degeneration (nNVAMD).
The medical and ICD9 billing records of all patients at Duke University Medical Center diagnosed with AMD (nNVAMD (362.50, 362.51) or NVAMD (362.52)) and tested for serum Vitamin D (vit D) level between 1996 and 2011 were retrospectively reviewed. Subjects were included with nNVAMD if prescribed AREDS vitamin supplementation and with NVAMD if confirmed treatment for choroidal neovascularization was initiated. Vit D levels were compared based on reference standards with significance level of p<0.05.
71 patients with NVAMD and 80 patients with nNVAMD were included. Patients were predominantly female (75%) and Caucasian (97%). Mean levels of 25-hydroxy vit D levels were 34.2 ng/mL (SD 12) and 31.1 ng/mL (SD 16) ng/ml in NNVAMD and NVAMD groups, respectively (p=0.17). Mean active 1, 25 (OH)2 Vit D level, tested in 22(15%) patients, was 36.8 pg/mL (SD 20) in nNVAMD and 20.2 pg/mL (SD 16) in NVAMD groups (p=0.048). Vit D insufficiency, to any degree based on laboratory reference values, was found in 16 (22%) nNVAMD and 29 (36%) NVAMD patients (p=0.07). Clinically significant vit D insufficiency (<20 ng/mL by 25-(OH) vit D serum testing) was more prevalent in NVAMD (29%) compared to nNVAMD (13%) patients (p=0.004).
Vitamin D levels demonstrate a trend towards lower mean levels in patients with NVAMD compared to nNVAMD. Vit D insufficiency was noted more commonly in patients with NVAMD, but clinically significant vit D insufficiency was significantly more prevalent, compared to nNVAMD patients. Given the anti-inflammatory and anti-angiogenic properties of Vitamin D, we suggest a potential role for Vitamin D testing and supplementation in patients with macular degeneration, however larger prospective trials are required.
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