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VITAMIN D DEFICIENCY IN NEOVASCULAR VERSUS NONNEOVASCULAR AGE-RELATED MACULAR DEGENERATION

Itty, Sujit MD*; Day, Shelley MD; Lyles, Kenneth W. MD‡,§,¶; Stinnett, Sandra S. DPH**; Vajzovic, Lejla M.*; Mruthyunjaya, Prithvi MD*

doi: 10.1097/IAE.0000000000000178
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Purpose: To compare 25-hydroxyvitamin D (25OHD) levels in patients with neovascular age-related macular degeneration (NVAMD) with patients with nonneovascular age-related macular degeneration and control patients.

Methods: Medical records of all patients diagnosed with age-related macular degeneration and tested for serum 25OHD level at a single medical center were reviewed. Control patients were selected from patients diagnosed with pseudophakia but without age-related macular degeneration. The lowest 25OHD level available for each patient was recorded.

Results: Two hundred sixteen patients with nonneovascular age-related macular degeneration, 146 with NVAMD, and 100 non–age-related macular degeneration control patients were included. The levels of 25OHD (mean ± SD) were significantly lower in NVAMD patients (26.1 ± 14.4 ng/mL) versus nonneovascular age-related macular degeneration (31.5 ± 18.2 ng/mL, P = 0.003) and control (29.4 ± 10.1 ng/mL, P = 0.049) patients. The prevalence of vitamin D insufficiency (<30 ng/mL 25OHD), deficiency (<20 ng/mL), and severe deficiency (<10 ng/mL) were highest in the NVAMD group. The highest quintile of 25OHD was associated with a 0.35 (95% confidence interval, 0.18–0.68) odds ratio for NVAMD.

Conclusion: This is the largest study to compare 25OHD levels in patients with the different clinical forms of age-related macular degeneration. Mean 25OHD levels were lower and vitamin D deficiency was more prevalent in NVAMD patients. These associations suggest that further research is necessary regarding vitamin D deficiency as a potentially modifiable risk factor for the development of NVAMD.

Supplemental Digital Content is Available in the Text.This retrospective study compared 25-hydroxyvitamin D levels in 462 patients with different forms of macular degeneration. Mean levels were lower, and vitamin D deficiency was more prevalent in patients with neovascular age-related macular degeneration compared with nonneovascular age-related macular degeneration and control patients.

*Department of Ophthalmology, Duke University Medical Center;

Department of Ophthalmology, Stanford Medical Center;

Department of Medicine, Duke University Medical Center;

§Geriatric Research Education and Clinical Centers, Veterans Affairs Medical Center, Durham, North Carolina;

The Carolinas Center for Medical Excellence, Cary, North Carolina; and

**Division of Biostatistics, Duke University Medical Center.

Reprint requests: Prithvi Mruthyunjaya, MD, Associate Professor of Ophthalmology, Vitreoretinal Surgery and Ocular Oncology, Duke Eye Center, DUMC 3802, Durham, NC 27710; e-mail: prithvi.m@duke.edu

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.retinajournal.com).

Presented in part at the Annual meeting of the American Society of Retina Specialists, Las Vegas, NV, August 2012; and at the Annual Meeting of the American Academy of Ophthalmology, Chicago, IL, November 2012.

Supported in part by NIH Grant 2P308716-06 (K.W.L).

None of the authors have any conflicting interests to disclose.

© 2014 by Ophthalmic Communications Society, Inc.