Vitamin D and Age-Related Macular Degeneration

Abstract

In recent years, the relationship between vitamin D and health has received growing attention from the scientific and medical communities. Vitamin D deficiencies have been repeatedly associated with various acute and chronic diseases, including age-related macular degeneration (AMD). Its active metabolite, 1α,25-dihydoxy vitamin D, acts as a modulator of cell proliferation, differentiation and apoptosis, and cumulative data from experimental and observational studies suggest that relatively a lower vitamin D status could be a potential risk factor for the development of early and/or late AMD. Herein, we made a narrative review of the mechanisms linking a potential role of vitamin D with the current concepts of AMD pathophysiology.

The Role of Diet, Micronutrients and the Gut Microbiota in Age-Related Macular Degeneration: New Perspectives from the Gut–Retina Axis

“…In these tissues, vitamin D may act as a paracrine/autocrine hormone, thereby regulating oxidation, inflammation and angiogenesis. A recent review by Layana et al [ 130 ] exposed several plausible mechanisms of action of vitamin D on AMD pathophysiology: protection against oxidative stress due to the generation of free ROS and lysosomal enzymes; possible inhibition of amyloid beta protein deposits, considered a primary activator of the complement cascade and inflammation; suppression of pro-inflammatory cytokines secreted by macrophages and microglia; and inhibition of angiogenesis, mediated by the inhibition of the transcription of hypoxia-inducible factor (HIF-1), induction of endothelial cell apoptosis and inhibition of the production of metalloproteinase, MMP-9.…”

“…One potential role of vitamin D deficiency in AMD is supported by many observational, cross-sectional and case-control studies, which correlated serum vitamin D levels or dietary vitamin intake with the risk of early or late AMD, although the present studies are heterogeneous and prospective studies are currently lacking [ 130 ]. However, although there is no robust evidence of a causal role of vitamin D deficiency in AMD pathogenesis, a protective role of vitamin D against chronic retinal inflammation should be considered in dietary programs and future studies.…”

Vitamin-D3 (α-1, 25(OH) 2D3) Protects Retinal Pigment Epithelium From Hyperoxic Insults

“…Modulation of VIT-D level can be a potential therapy in retinal disease driven by hyperoxia. 6 The RPE-340 cells cultured with 40% oxygen (hyperoxia condition) generated modest oxidative stress without cell death and cytotoxicity but altered the phenotype of cells. 20 In this study, the oxidative stress was reduced in PRPE cells cultured in hyperoxia (40% oxygen) with VIT-D (see Supplementary Fig.…”

“…6−8 These studies implicated deficiency of VIT-D to higher risk for early/late AMD, whereas a supplementation leads to delay or prevention in the progression of AMD. 6,9 Although VIT-D receptors as well as enzymes for VIT-D metabolism are present in the retina, choroid, and retinal pigment epithelium (RPE) cells, their functions are still not well understood. 6 VIT-D has been studied as a potential inhibitor of angiogenesis in a mouse model of oxygen-induced ischemic retinopathy (OIR).…”

Age-related Macular Degeneration and Risk Factors Associated with Nutrition

“…Drusenlerin oluşumuna neden olan ekstrasellüler amiloid-β proteinlerinin birikimini önleyerek makula dejenerasyonuna karşı koruyucu rol oynamaktadır. 62 Yapılan çalışmalarda da genel olarak D vitamininin makula dejenerasyonuna karşı koruyucu olduğu gösterilmiştir. Yaşa Bağlı Göz Hastalıkları Çalışması (AREDS)' nın sonuçlarına göre yaygın orta büyüklükte druseni, en az 1 büyük druseni, bir veya her iki gözünde de merkezi olmayan coğrafik atrofisi olanlarda veya ileri dönem makula dejenerasyonu olanlarda veya makula dejenerasyonu nedenli bir gözünde görme kaybı olanlarda ve sigara kullanımı kontraendikasyonu olmayanlarda antioksidanlar (500 mg C vitamini, 400 IU E vitamini ve 15 mg beta karoten) ve çinko (80 mg çinko oksit ve potansiyel anemiyi önlemek için 2 mg kuprik oksit) içeren suplementasyon önerilmiştir.…”