Low Serum 25-Hydroxyvitamin D Levels Are Associated with Dry Eye Syndrome

Abstract

BackgroundDry eye syndrome (DES) is a common tear film and ocular surface disease that results in discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface. Systemic diseases associated with DES include diabetes mellitus, rheumatoid arthritis, depression, anxiety, thyroid disease, allergic diseases, irritable bowel syndrome, chronic pain syndrome, and hyperlipidemia. Interestingly, it has been found that most of these are associated with low levels of serum 25-hydroxyvitamin D (25(OH)D) or inadequate sunlight exposure.MethodsIn this cross-sectional data analysis, noninstitutionalized adults aged ≥19 years (N = 17,542) who participated in Korean National Health and Nutrition Examination Survey 2010–2012 were included. Information regarding duration of sunlight exposure was collected from the survey participants. Serum 25(OH)D and zinc levels were measured. The confounding variables were age, gender, sunlight exposure time, region of residence, obesity, serum 25(OH)D level, diabetes mellitus, rheumatoid arthritis, depression, thyroid disorder, atopic dermatitis, history of ocular surgery, regular exercise, and walking exercise.ResultsMean serum 25(OH)D levels of subjects with and without DES were 16.90 ± 6.0 and 17.52 ± 6.07 (p<0.001). Inadequate sunlight exposure time (odds ratio [OR], 1.554; 95% confidence interval [CI], 1.307–1.848), urban residence (OR, 1.669; 95% CI, 1.456–1.913), indoor occupation (OR, 1.578; 95% CI, 1.389–1.814), and low serum 25(OH)D level (OR, 1.158; 95% CI, 1.026–1.308) were the risk factors for DES. After adjusting for age, sex, obesity, diabetes mellitus, rheumatoid arthritis, depression, thyroid disorder, atopic dermatitis, history of ocular surgery, regular exercise, and occupation, low serum 25(OH)D level (OR, 1.178; 95% CI, 1.010–1.372) and deficient sunlight exposure time (OR, 1.383; 95% CI, 1.094–1.749) were the risk factors for diagnosed DES.ConclusionLow serum 25(OH)D levels and inadequate sunlight exposure are associated with DES in Korean adults. These results suggest that sufficient sunlight exposure or vitamin D supplementation may be useful in DES treatment.

Ocular symptoms and tear film break up time (BUT) among junior high school students in Penang, Malaysia – Associations with fungal DNA in school dust

“…One recent study concluded that low serum levels of 25-hydroxyvitamin D are associated with dry eye syndrome, indicating that there could be a latitude effect on ocular symptoms related to degree of exposure to sunshine (Yoon et al, 2016). We found only three studies on dry eye symptoms and BUT from tropical countries in Asia.…”

Correlation of vitamin D levels with tear film stability and secretion in patients with dry eye syndrome

“…; Yoon et al. ). Further study should be necessary to analyse the relationship between vitamin D and DES using logistic regression.…”

“…Another limitation of this study is that it is not possible to adjust potential confounding factors. Age, gender, diabetes mellitus, irritable bowel syndrome, rheumatoid arthritis, depression, thyroid disease, atopic dermatitis or ocular surgery can be considered as potential confounding factors for DES (Galor et al 2011;Vehof et al 2014;Yoon et al 2016). Further study should be necessary to analyse the relationship between vitamin D and DES using logistic regression.…”

Dry Eye and its Relationship with Status of Serum Calcium in the Body at a Tertiary Care Institute: A Case Control Study

“…It is observed in the present study that those taking vegetarian diet were 1.30 times more prone to dryness than those taking mixed diet. Dadaci Z, Yildirim P, Yoon SY found that Serum Calcium levels were also reported to be associated with some ocular surface conditions such as dry eye and allergic conjunctivitis [17][18][19] . Suzuki T, Dang ST states that in vivo reports provide evidence concerning the antiinflammatory and immunomodulatory roles of serum calcium in the corneal region 20,21 .…”