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COMPLICATIONS diabetes (DoD) and poor glycemic control (2). Genetic factors are also implicated, with heritability of 52% for proliferative DR (PDR) (3,4). Several candidate gene and genome-wide association studies (GWAS) have been conducted (5-11). Although several polymorphisms have been suggested to be associated with DR, few have been convincingly replicated (10,12-15). There are several reasons why studies have not yielded consistent findings. The genetic effects are likely modest, and identification requires large sample sizes. Previous studies have not consistently accounted for the strongest two covariates, DoD and glycemic control. Liability threshold (LT) modeling is one way to incorporate these covariates while also increasing statistical power (16). Finally,

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Purpose-To determine if hyperreflective foci (HF) and macular thickness on spectral domain ocular coherence tomography (SD-OCT) are associated with lipid levels in type 2 diabetes (T2D) patients.Methods-238 participants from four sites had fundus photographs and SD-OCT images graded for hard exudates (HE) and HF, respectively. Regression models were used to determine the association between serum lipid levels and (1) presence of HF and HE and (2) central subfield macular thickness (CSMT), central subfield macular volume (CSMV) and total macular volume (TMV).Results-All patients with HE on fundus photographs had corresponding HF on SD-OCT but 57% of patients with HF on OCT did not have HE detected in their fundus photographs. Presence of HF was associated with higher total cholesterol [(odds ratio (OR) = 1.13, 95% confidence interval (CI) = 1.01-1.27, P = 0.03] and higher low density lipoprotein (LDL) levels (OR = 1.17, This submission has not been published anywhere previously and is not simultaneously being considered for any other publication. HHS Public Access Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript 95% CI = 1.02-1.35, P = 0.02) in models adjusting for other risk factors. The TMV was also associated with higher total cholesterol (p = 0.009) and triglyceride (p = 0.02) levels after adjusting for other risk factors.Conclusion-Higher total and LDL cholesterol were associated with presence of HF on SD-OCT. TMV was associated with higher total cholesterol and triglyceride levels.

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IMPORTANCE Vitamin D plays an important role in both the innate and adaptive immune systems. It has been shown to contribute to the etiology of T-cell-mediated autoimmune diseases through the upregulation of type 2 anti-inflammatory T helper cells and the suppression of type 1 T helper cells. Noninfectious uveitis is postulated to be caused by immune dysfunction. OBJECTIVE To determine whether there is an association between vitamin D levels and noninfectious anterior uveitis.DESIGN, SETTING, AND PARTICIPANTS This was a case-control study. We identified patients with and without noninfectious uveitis using the Massachusetts Eye and Ear Infirmary Ocular Inflammation Database and electronic medical records from March 1, 2008, to December 12, 2015, at the Massachusetts Eye and Ear Infirmary Uveitis and Comprehensive Ophthalmology Clinics. One hundred patients with noninfectious anterior uveitis and 100 patients without uveitis were recruited. Patients with noninfectious uveitis were diagnosed by fellowship-trained uveitis specialists after exclusion of infectious causes and neoplastic masquerades of uveitis. All patients included had a total 25-hydroxyvitamin D level recorded. Multivariate regression models were constructed to determine the association between vitamin D levels and the presence of uveitis. MAIN OUTCOME AND MEASURE Presence of noninfectious anterior uveitis. RESULTSWe identified 100 patients (64 white, 8 African American, 25 Asian, and 3 Hispanic) with a mean (SD) age of 51.8 (15.9) years (26 men) and 100 control individuals (58 white, 23 African American, 8 Asian, and 11 Hispanic) with a mean (SD) age of 53.6 (16.2) years (27 men). Hypovitaminosis D was associated with noninfectious uveitis in the univariate analysis (odds ratio, 2.53; 95% CI, 1.42-4.51; P = .002). The association in multivariate regression after adjusting for age, sex, and race/ethnicity was 2.96 (95% CI, 1.60-5.50; P = .001). The odds of developing uveitis were 4% lower for every 1-ng/mL increase in vitamin D level (odds ratio, 0.96; 95% CI, 0.93-0.99; P = .01) in the main multivariate analysis. CONCLUSIONS AND RELEVANCEIn this retrospective study, lower vitamin D levels were associated with an increased risk of noninfectious anterior uveitis. However, this does not confirm a causal effect.