Do serum vitamin D levels correlate with Macular Edema or with Diabetic Retinopathy?

Abstract

Purpose To compare serum vitamin D (25(OH)D) levels according to the presence of diabetic macular edema (DME) in Diabetes Mellitus (DM) patients with different retinopathy conditions. Methods The files of all DM patients presenting for examination at the ophthalmology clinic between October 2018 and March 2020 were retrospectively examined. Data was collected from the files and included a comprehensive ophthalmological examination, laboratory results from fasting blood tests, and the internal medicine outpatient clinic examination. Patients were divided into two groups according to the presence of DME, they were divided into three groups in terms of retinopathy and DME, and in terms of retinopathy severity and presence of DME, they were divided into five groups. Result Ninety one (51.1%) of the age-sex matched participants were female and 87 (48.9%) were male. There was a statistically significant difference in vitamin D levels between the group with DME and the group without DME (p ≤ 0.001). In the comparison made according to the presence of retinopathy and DME; a significant difference was found between the DME group and the group with retinopathy but no DME (p ≤ 0.001). When the severity of retinopathy and the presence of DME were evaluated, a significant difference was found between the proliferative diabetic retinopathy (PDR) group with DME and the PDR group without DME in terms of vitamin D levels (p = 0.004). Conclusion Our study shows that the presence of DME is associated with lower serum 25(OH)D levels.

The Role of Vitamin D3 in Ocular Diseases

“…Age-related macular degeneration leads to blur or complete loss of central vision. Individuals who suffer from this condition tend to have lower levels of vitamin D than healthy ones [ 40 , 41 , 42 ]. Vitamin D 3 exhibits protective properties against oxidative stress.…”

“…This condition is identified by the leakage of retinal vessels, compromised endothelial integrity, and the accumulation of exudative fluid in the macula. The prevalence of DME corresponds with inadequate vitamin D concentrations [ 42 ]. Other results indicate that rectifying vitamin D deficiency (VDD) in DME patients receiving anti-VEGF therapies has a positive impact on sustaining the improvement in visual acuity and reducing central macular thickness observed with these treatments over a period of six months [ 65 ].…”

Serum vitamin D is substantially reduced and predicts flares in diabetic retinopathy patients

“…It has also been suggested that the balance of inflammatory mediators is disrupted in diabetic retinopathy, which results in the production of vascular endothelial growth factors, chemokines, and adhesion molecules that lead to retinal vascular damage 5 , 6 . Moreover, some studies have suggested that vitamin D deficiency is closely associated with diabetic retinopathy 7 , 8 , 9 .…”

Reduced vitamin D levels in diabetic retinopathy: cause or effect?

“…It has also been suggested that the balance of in ammatory mediators in DR is disrupted, producing vascular endothelial growth factors, chemokines, and adhesion molecules that lead to retinal vascular damage [5,6]. Meanwhile, some studies have suggested that vitamin D de ciency is closely associated with DR [7][8][9].…”