Background In the older population, retinal vein occlusion (RVO) is a major contributor to vision loss and blindness. RVO is the second most common form of retinal vascular disease, following diabetic retinopathy. On the other hand, there is a paucity of studies on vitamin D insufficiency and its influence on the causation of RVOs. The goal of this study is to demonstrate a link between vitamin D levels of individuals in rural India who have RVOs. Methods This study is a hospital-based prospective case-control study. All patients aged 18 years and above with RVO visiting the ophthalmology outpatient department at a tertiary care facility in central India and all controls in the same age group were chosen for the study after taking into consideration inclusion and exclusion criteria. Fasting for 12 hours prior to blood sample collection was required of all participants. The total vitamin D concentration in the serum was determined using tandem mass spectrometry after it had been frozen at 20°C. For this study, vitamin D levels were collected from 70 participants. Results The average age is 60, with a standard variation of 10 for both cases and controls. There is a 49% prevalence of central RVO (CRVO), 34% prevalence of inferotemporal branched RVO (IT BRVO), and 17% prevalence of superotemporal BRVO (ST BRVO). Twenty percent of the 35 patients were deficient in vitamin D, and 80% had insufficient levels. No case patient had vitamin D levels within the normal range. No one with vitamin D insufficiency was found among the 35 controls. Twenty-five percent of the patients had adequate vitamin D levels, but only 28.6% of the controls did. The p-value of 0.01 indicates a remarkable difference in vitamin D levels between the diagnosed cases and controls. Cases had mean vitamin D levels of 21.408 +/− 4.947 ng/dl, while controls had mean levels of 37.808 +/− 11.799 ng/dl. Vitamin D levels did not differ significantly across RVO subtypes. The study also shows the association of RVO with hypertension (HTN) and dyslipidemia as the p-value was noted to be significant (p = 0.0147 < p = 0.05) for HTN with an odds ratio of 3.43 (CI, 1.25-9.4) and was significant (p = 0.0404 < p = 0.05) for dyslipidemia with an odds ratio of 4.87 (CI, 0.96-24.97). Diabetes, smoking, hyperhomocysteinemia, dyslipidemia, cardiovascular disease, and cerebrovascular accident are all well-known risk factors, but we found no evidence associating them together. Conclusion Vitamin D proved to be an important risk factor in the causation of RVOs. Other risk factors like HTN and dyslipidemia also showed significant relation in the study. Vitamin D levels should be advised as a routine investigation in patients who are diagnosed with RVOs along with screening for other risk factors. Vitamin D supplementation should be given as prophylaxis in cases of deficiency.
Background: Retinal vein occlusion in diabetic retinopathy resulting in visual impairment and complete vision loss is well-known especially in older population. Ischemic occlusion of retinal vein can cause macular edema, macular ischemia and neovascularization which might end up in complete vision loss. Role of Vitamin D in maintaining vasculature and function of endothelium is evident from a number of studies. This study aims to estimate vitamin D levels in individuals with retinal vein occlusions. Methodology: This will be a hospital based case control study conducted in Ophthalmology department of AVBRH, Wardha. About 70 consecutive patients will be enrolled and assigned to Case and Control groups of 35 each. Vitamin D levels will be estimated in all 70 patients. Including best corrected visual acuity (snellens chart), slit lamp inspection, intraocular pressure (IOP) measurement (Applanation tonometer) and fundoscopy (slit lamp biomicroscopy with 90 D) will be performed on all patients. Data will be collected, tabulated and compiled. Statistical analysis will be done by using unpaired student t test and Chi square test. Expected results: Expected findings include deficient vitamin D levels in patients with retinal vein occlusion. Conclusion: Retinal vein Occlusions are a leading reason for vision impairment which is preventable by timely treatment with Vitamin D.
One of the most important differentials for painless sudden loss of vision is CRVO (Central retinal vein occlusion). It is one of the leading diseases causing vision loss especially in elderly population. However, bilateral simultaneous CRVO in a young patient with no other co morbidities is rare. This case illustrates a young male of 40 years with no well-known comorbidities who experienced sudden onset diminution of vision in right eye followed by left eye in 2 weeks gap. No history of smoking, diabetes, hypertension, dyslipidemia or any other systemic disorders. Patient is not on any topical or systemic medications. There was no significant family history.On evaluation of right eye, the BCVA (best corrected visual acuity) was 6/36 and left eye was finger counting 3 meters. Intra ocular pressure in both eyes was 18 mm Hg. Anterior segment showed all normal findings. Dilated fundus evaluation in both eyes showed multiple superficial and deep hemorrhages with hard exudates and macular edema. OCT (Optical Coherence tomography) displayed macular edema in both eyes. Blood investigations showed all values within normal limits except Vitamin D levels which were found to be deficient.
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