Kim Kyoung Lae, Park Sung Pyo
Department of Ophthalmology, Hallym University College of Medicine, Kangdong Sacred Heart Hospital, Gangdong-gu, Seoul, South Korea.
Medicine (Baltimore). 2018 Aug;97(33):e11908. doi: 10.1097/MD.0000000000011908.
The objective of this study was to evaluate the association between serum vitamin D deficiency and age-related macular degeneration (AMD) in Koreans through a clinical case-control pilot study. The study included 96 patients: 30 with late AMD, 32 with early AMD, and 34 normal controls. The patients with late AMD were divided into 2 subgroups based on the presence or absence of subretinal fibrosis on optical coherence tomography (OCT) images. We measured 25-hydroxyvitamin D levels in the serum of all patients during the same season to rule out seasonal variation of serum vitamin D level. Serum vitamin D deficiency was defined as a serum 25-hydroxyvitamin D level below 20 ng/mL. Serum vitamin D deficiency had a tendency to increase the risk of early AMD, although with borderline significance [odds ratio (OR) = 3.59; 95% confidence interval (95% CI) 0.95-13.58; P = .060]. It was significantly associated with a greater risk of late AMD (OR = 3.61; 95%CI 1.04-12.51; P = .043). Among the 2 subgroups of patients with late AMD, those with subretinal fibrosis present on the OCT images showed a greater risk of serum vitamin D deficiency than the normal controls (OR = 7.54; 95% CI 1.34-42.51). However, there was no significant association between serum vitamin D deficiency and late AMD without subretinal fibrosis (OR = 1.89; 95% CI 0.40-8.92). Serum vitamin D deficiency may increase the risk of early and late AMD in Koreans, and may also be associated with subretinal fibrosis in this population.
本研究的目的是通过一项临床病例对照初步研究,评估韩国人血清维生素D缺乏与年龄相关性黄斑变性(AMD)之间的关联。该研究纳入了96例患者:30例晚期AMD患者、32例早期AMD患者和34例正常对照。晚期AMD患者根据光学相干断层扫描(OCT)图像上是否存在视网膜下纤维化分为2个亚组。我们在同一季节测量了所有患者血清中的25-羟基维生素D水平,以排除血清维生素D水平的季节性变化。血清维生素D缺乏定义为血清25-羟基维生素D水平低于20 ng/mL。血清维生素D缺乏有增加早期AMD风险的趋势,尽管具有临界显著性[比值比(OR)=3.59;95%置信区间(95%CI)0.95-13.58;P=0.060]。它与晚期AMD的更高风险显著相关(OR=3.61;95%CI 1.04-12.51;P=0.043)。在晚期AMD患者的2个亚组中,OCT图像上存在视网膜下纤维化的患者血清维生素D缺乏的风险高于正常对照(OR=7.54;95%CI 1.34-42.51)。然而,血清维生素D缺乏与无视网膜下纤维化的晚期AMD之间无显著关联(OR=1.89;95%CI 0.40-8.92)。血清维生素D缺乏可能会增加韩国人早期和晚期AMD的风险,并且也可能与该人群的视网膜下纤维化有关。