Service of Ophthalmology, Centro Hospitalar Universitário do Porto, Largo do Prof. Abel Salazar, Porto, Portugal; Unit of Anatomy, Department of Biomedicine, Faculty of Medicine of University of Porto, Al. Professor Hernâni Monteiro, Porto, Portugal.
Service of Ophthalmology, Centro Hospitalar Universitário do Porto, Largo do Prof. Abel Salazar, Porto, Portugal.
Surv Ophthalmol. 2021 Mar-Apr;66(2):183-197. doi: 10.1016/j.survophthal.2020.07.003. Epub 2020 Aug 5.
Vitamin D may be implicated in the pathophysiology of several ocular diseases, but its role in age-related macular degeneration (AMD) remains uncertain. We sought to review systematically the existing evidence to evaluate the association between serum 25-hydroxyvitamin D 25(OH)D levels and AMD. A four-database search (PubMed, ISI Web of Science, Cochrane, and Scopus) was performed from inception to May 2020 using the MeSH terms: ("Macular Degeneration" OR "Age-related macular degeneration" OR "Retinal degeneration" OR "Macula lutea") AND ("Vitamin D" OR "Ergocalciferols" OR "Cholecalciferol" OR "25-Hydroxyvitamin D"). Random-effects meta-analyses were performed to compute 1) the standard mean difference in 25(OH)D concentration between AMD and non-AMD patients and 2) the AMD risk according to serum 25(OH)D levels. Eighteen observational studies enrolling 75,294 patients after a selection process among 375 original abstracts were selected. No significant differences were found, but there appears to exist a trend for late AMD among subjects with a serum 25(OH)D level below 50 nmol/L (odds ratio, 1.8; 95% confidence interval: 1.00-3.24, P = 0.05). There is no clear evidence of a definitive association between serum 25(OH)D and AMD risk, mainly due to heterogeneity in study procedures and lack of longitudinal designs.
维生素 D 可能与几种眼部疾病的病理生理学有关，但它在年龄相关性黄斑变性（AMD）中的作用仍不确定。我们旨在系统地回顾现有证据，以评估血清 25-羟维生素 D（25[OH]D）水平与 AMD 之间的关系。从建库到 2020 年 5 月，我们使用 MeSH 术语在四个数据库（PubMed、ISI Web of Science、Cochrane 和 Scopus）中进行了搜索：（“黄斑变性”或“年龄相关性黄斑变性”或“视网膜变性”或“黄斑”）和（“维生素 D”或“麦角钙化醇”或“胆钙化醇”或“25-羟维生素 D”）。我们采用随机效应荟萃分析计算了 1）AMD 患者与非 AMD 患者血清 25（OH）D 浓度的标准均数差，以及 2）根据血清 25（OH）D 水平，AMD 的发病风险。在对 375 篇原始摘要进行选择后，共有 18 项观察性研究纳入了 75294 名患者。结果并未发现显著差异，但在血清 25（OH）D 水平低于 50nmol/L 的患者中，似乎存在晚期 AMD 的趋势（比值比，1.8；95%置信区间：1.00-3.24，P=0.05）。血清 25（OH）D 与 AMD 风险之间没有明确的关联证据，主要是由于研究程序的异质性和缺乏纵向设计。
