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Jessica L. Cao, Ashley Balascoe, sruthi arepalli, Arthi Venkat, Careen Y Lowder, Sunil K Srivastava, Sumit Sharma; Vitamin D Levels in Sarcoid and Non-Sarcoid Uveitis. Invest. Ophthalmol. Vis. Sci. 2020;61(7):4915.
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Recent literature suggests that there is an association between low 25-hydroxy vitamin D (25-HVD) levels and an increased risk of noninfectious anterior uveitis. In sarcoidosis, it is hypothesized that granulomatous tissues contain 1-alpha hydroxylase enzyme that converts 25-hydroxy vitamin D to 1, 25-dihydroxy vitamin D (1, 25-DHVD), leading to elevated levels of 1, 25-DHVD. The purpose of this study is to determine if there is an association between 1, 25-DHVD and 25-HVD levels and development of sarcoid uveitis.
This was a retrospective case-control study of patients at least 18 years of age who had serum levels of 25-HVD and 1, 25-DHVD checked on the same day within 1 week of diagnosis of active uveitis (including anterior, intermediate, posterior, panuveitis, scleritis, and keratitis). Patients were excluded if they were not diagnosed by a Cole Eye Institute uveitis provider between 2016 and 2019. A ratio of 1, 25-DHVD to 25-HVD levels was calculated for those with biopsy-proven definite sarcoid uveitis (DSU), probable non-biopsy proven sarcoid uveitis (PSU), and those without sarcoid uveitis (NSU). ANOVA was used to determine if there was a statistical difference (p < 0.05) in mean 25-HVD levels, 1, 25-DHVD levels, and ratio of 1, 25-DHVD to 25-HVD.
Forty-one patients, including 14 with DSU/PSU (mean age 58.0 +/- 13.8 years; 2 males, 12 females) and 27 with NSU (mean age 53.0 +/- 20.8 years; 6 males, 21 females) were included in the analysis. The mean 25-HVD level was 24.6 +/- 12.4 ng/mL, 38.9 +/- 12.6 ng/mL, and 32.5 +/- 17.2 ng/mL for the PSU, DSU, and NSU groups, respectively (p = 0.25). The mean 1, 25-DHVD level was 73.2 +/- 37.8 pg/mL, 35.9 +/- 15.8 pg/mL, and 42.6 +/- 14.5 pg/mL for the PSU, DSU, and NSU groups, respectively (p = 0.0017). The mean 1, 25-DHVD to 25-HVD ratios of the PSU, DSU, and NSU groups were 3.63 +/- 2.13, 0.99 +/- 0.49, and 1.71 +/- 1.09 (p = 0.00071).
While there was no statistically significant difference in 25-HVD levels between the groups, there was a difference in 1, 25-DHVD levels with the highest levels in the PSU groups followed by the NSU and DSU groups. There was also a difference in 1, 25-DHVD to 25-HVD ratios with the lowest mean ratio seen in the DSU group.
This is a 2020 ARVO Annual Meeting abstract.
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