Association Between Serum Vitamin D Level and Rates of Structural and Functional Glaucomatous Progression

Abstract

Précis: In a retrospective cohort study, serum vitamin D levels were not associated with rates of structural or functional loss in glaucoma patients, suggesting that low vitamin D level is not a risk factor for progression. Purpose: To investigate the association between serum vitamin D level and rates of functional and structural glaucomatous loss over time. Methods: This study included 826 eyes of 536 glaucoma or suspect patients with an average follow-up of 4.8±1.9 years. All patients had at least 1 serum vitamin D measurement, and all eyes had at least 2 reliable standard automated perimetry (SAP) tests and 2 spectral-domain optical coherence tomography (SD OCT) tests with a minimum follow-up of 6 months. Multivariable linear mixed-effects models were used to estimate the association of vitamin D level with rates of change in SAP mean deviation (MD) and OCT retinal nerve fiber layer (RNFL) thickness over time while adjusting for potential confounding factors. Results: Patients had an average of 3.4±1.7 SAP tests, 4.8±1.9 SD OCT tests, and 2.3±1.9 vitamin D measurements. The average serum vitamin D level was 33.9±13.2 ng/mL. Mean rates of MD and RNFL change were −0.03±0.08 dB/y and −0.68±0.64 µm/y, respectively. After controlling for confounding factors, there was no statistically significant association between mean vitamin D level and rates of MD (β=0.038, 95% CI: −0.006, 0.082, P=0.09) or RNFL loss over time (β=−0.018, 95% CI: −0.092, 0.055, P=0.62). Conclusions: We did not find a significant association between vitamin D level and rates of visual field or RNFL loss over time in individuals with glaucoma and glaucoma suspect patients.

The Role of Vitamin D3 in Ocular Diseases

“…Taking into consideration the progression of glaucoma, there seems to be no connection with serum vitamin D levels. If vitamin D is expected to provide metabolic protection against the advancement of glaucoma, there is no apparent clinical manifestation of these changes [ 73 ]. A similar conclusion was drawn in a pilot study from Saudi Arabia, which aimed to investigate the association of decreased serum 25-OHD concentration with the cup/disc (C/D) ratio in primary open-(POAG) and closed-angle glaucoma (PACG).…”