Abstract
Purpose :
The role of abnormal vitamin D and B levels in various neurological conditions has previously been established. However, to date, the relationship between vitamin levels and neuropathic corneal pain (NCP), a condition characterized by abnormal nerve function, has not been studied. Herein, we aim to explore these vitamin abnormalities as a possible underlying etiology in NCP.
Methods :
In this retrospective study on patients with NCP, a search was conducted of electronic medical records to identify patients seen at New England Eye Center from January 2015 - March 2022 with a diagnosis of ocular pain. Patients were included if diagnosed with NCP and had serology results for vitamin B12, B6, B2, or D (D 25-OH) and excluded if on systemic pain medications at the first visit. Serology results and demographics were collected. Binary logistic regressions and contingency tables were used to assess the odds of an abnormal test result compared to normal levels based on demographics.
Results :
The majority of the 84 patients (age: 40.8 ± 12.9 years) included in this study were female (65.5%), white (77.4%), and of Non-Hispanic or Latino origin (82.1%). At least one vitamin abnormality was found in 52.4% of patients, most common being low B2 (31.0%), high B6 (28.9%), high B12 (15.0%), and low vitamin D (15.8%). Males had higher odds than females of having a vitamin D3 deficiency (OR: 4.5, CI: 1.2-18.9, p= 0.025). The predictive value of having a vitamin D3 deficiency decreased as age increased (OR: 0.9, CI: 0.86-0.99, p = 0.028). Specifically, patients aged 18-33 had higher odds of having vitamin D3 deficiency than others (OR: 4.89, CI: 1.3-18.3, p = 0.018). No category of race was at greater risk for a vitamin abnormality, and no demographic group was at greater risk for vitamin B abnormality (all p< 0.05).
Conclusions :
Our findings indicate that vitamin abnormalities are common in patients with NCP, specifically low B2, high B6, and low vitamin D. High vitamin B6 levels was one of the most common findings, supporting literature that B6 toxicity may lead to neuropathy. Vitamin D deficiencies are more common in patients 18-30 years and in males. Serology testing may help treat underlying conditions early, especially in males under 33. Investigating changes in clinical findings/pain after treating abnormal levels would further illustrate the role vitamins play in NCP.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.