Vitamin D Supplementation for Patients with Dry Eye Syndrome Refractory to Conventional Treatment

Bae, So Hyun; Shin, Young Joo; Kim, Ha Kyoung; Hyon, Joon Young; Wee, Won Ryang; Park, Shin Goo

doi:10.1038/srep33083

Cited by 61 publications

(56 citation statements)

References 47 publications

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“…These observations are clinically relevant because oral vitamin D supplementation is being explored in DED management, which shows favorable outcomes by enhancing the efficacy of topical treatment and improving various DED signs and symptoms, particularly in those with vitamin D deficiency or those refractory to conventional treatment. [75][76][77] To summarize, an imbalance in nociception modulators with an increase in pronociceptive factors and a decrease in antinociceptive factors was observed ( Fig. 7) to be significantly associated with signs and symptoms in DED patients.…”

Section: Tear Factors Associated With Dry Eye Signs and Symptomsmentioning

confidence: 78%

Dysregulated Tear Fluid Nociception-Associated Factors, Corneal Dendritic Cell Density, and Vitamin D Levels in Evaporative Dry Eye

Khamar

Nair

Shetty

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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Citation: Khamar P, Nair AP, Shetty R, et al. Dysregulated tear fluid nociception-associated factors, corneal dendritic cell density, and vitamin D levels in evaporative dry eye. Invest Ophthalmol Vis Sci. 2019;60:2532-2542. https://doi.org/10.1167 PURPOSE. The purpose of this study was to study the status and association among tear-soluble factors, corneal dendritic cell density, vitamin D, and signs and symptoms in dry eye disease (DED). METHODS.A total of 33 control subjects and 47 evaporative dry eye patients were included in the study. DED diagnosis and classification was based on the 2017 Report of the Tear Film & Ocular Surface Society International Dry Eye Workshop (TFOS DEWS II). DED workup, including tear film break-up time (TBUT), Schirmer's test I (STI), corneal and conjunctival staining, ocular surface disease index (OSDI) scoring, and in vivo confocal microscopy (to assess corneal dendritic cell density [cDCD] and subbasal nerve plexus [SBNP] features) was performed in the study subjects. Tear fluid using Schirmer's strip and serum were collected from the subjects. Multiplex ELISA or single analyte ELISA was performed to measure 34 tearsoluble factors levels including vitamin D.RESULTS. Significantly higher OSDI discomfort score, lower TBUT, and lower STI were observed in DED patients. cDCD was significantly higher in DED patients. No significant difference was observed in SBNP features. Tear fluid IL-1b, IL-17A, MMP9, MMP10, MMP9/ TIMP ratio, and VEGF-B were significantly higher in DED patients. Significantly lower tear fluid IL-2, IP-10, NPY, VEGF-A, and vitamin D was observed in DED patients. These dysregulated tear factors showed significant associations with DED signs and symptoms.CONCLUSIONS. Altered tear fluid soluble factors with potential to modulate nociception exhibited a distinct association with ocular surface discomfort status, TBUT, STI, and cDCD. This implies a functional relationship between the various tear-soluble factors and dry eye pathogenesis, indicating new molecular targets for designing targeted therapies.

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Section: Tear Factors Associated With Dry Eye Signs and Symptomsmentioning

confidence: 78%

Dysregulated Tear Fluid Nociception-Associated Factors, Corneal Dendritic Cell Density, and Vitamin D Levels in Evaporative Dry Eye

Khamar

Nair

Shetty

et al. 2019

Invest. Ophthalmol. Vis. Sci.

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“…Starting from these assumptions, vitamin D has been investigated as a potential therapy for DED. Bae and co-authors evaluated the efficacy of vitamin D supplementation in patients with DED refractory to conventional treatment who presented vitamin D deficiency, and reported a significant improvement of Schirmer test, break-up time, corneal staining, eyelid margin hyperemia and subjective discomfort symptoms [91]. In agreement with these results, Yang and co-workers observed a significant improvement of dry eye symptoms and corneal staining after 2 months of vitamin D supplementation [92] Furthermore, the therapeutic effect of tear substitutes depends on serum vitamin D levels, and oral supplementation has shown to synergistically enhance their efficacy [93].…”

Section: Vitamin Dmentioning

confidence: 99%

The Role of Nutrition and Nutritional Supplements in Ocular Surface Diseases

et al. 2020

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Dry eye disease (DED) is a multifactorial disease of the ocular surface system whose chore mechanisms are tear film instability, inflammation, tear hyperosmolarity and epithelial damage. In recent years, novel therapies specifically targeting inflammation and oxidative stress are being investigated and used in this field. Therefore, an increasing body of evidence supporting the possible role of different micronutrients and nutraceutical products for the treatment of ocular surface diseases is now available. In the present review, we analyzed in detail the effects on ocular surface of omega-3 fatty acids, vitamins A, B12, C, D, selenium, curcumin and flavonoids. Among these, the efficacy of omega-3 fatty acid supplementation in ameliorating DED signs and symptoms is supported by robust scientific evidence. Further long-term clinical trials are warranted to confirm the safety and efficacy of the supplementation of the other micronutrients and nutraceuticals.

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“…Meng YF, et al have also reported that Serum 25(OH) levels were significantly lower in DES subjects of their study [19.3+/-5.8 ng/ml] as compared to their control subjects [31.6+/-7.3], which was statistically significant, p-value <0.001[13]. Seok Hyun Bae, et al also found deficient levels of Vitamin D [10.52+/-4.61] in DES subjects of their study group[16].…”

mentioning

confidence: 63%

Serum Vitamin D & Dry Eye Syndrome

Shaveta¹,

Nawaz

2019

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Introduction: Dry eye syndrome [DES] is one of the commonest ocular disorders characterized by tear film instability, visual discomfort & disturbance with ocular surface inflammation potentially leading to damage to the ocular surface. Serum Vitamin-D deficiency has been reported to be associated with DES. Aim: To determine the Serum 25-hydroxy-vitamin-D levels in patients diagnosed as having DES. Methods: We conducted a prospective observational study and included in our study, serum vitamin D levels of the first 40 patients over the age of 18 years presenting with signs and symptoms and later diagnosed to have DES [confirmed with ocular surface disease index-OSDI questionnaire, Schirmer I test, kerato-epitheliopathy examination and tear-film breakup time-[TBUT] were analysed. Results: Schirmer's I test, interpreted as mild [11-15mm/5min], moderate [6-10 mm/5 min] and severe [<5mm/5min] had 8, 17 and 15 patients, respectively, with a mean value of 8 mm/5 min Schirmers I test. The minimum and maximum of Fluorescein TBUT measured in seconds was 4 and 10 seconds, respectively, with a mean of 6.2 seconds. Twenty four of our test subjects were found to have deficient Serum Vit 25[OH] D levels, nine had insufficient levels and seven had normal levels. Conclusion: Vitamin D deficiency is prevalent in patient having DES.

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Vitamin D Supplementation for Patients with Dry Eye Syndrome Refractory to Conventional Treatment

Cited by 61 publications

References 47 publications

Dysregulated Tear Fluid Nociception-Associated Factors, Corneal Dendritic Cell Density, and Vitamin D Levels in Evaporative Dry Eye

Dysregulated Tear Fluid Nociception-Associated Factors, Corneal Dendritic Cell Density, and Vitamin D Levels in Evaporative Dry Eye

The Role of Nutrition and Nutritional Supplements in Ocular Surface Diseases

Serum Vitamin D & Dry Eye Syndrome

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