Positive Association between Blood 25-Hydroxyvitamin D Levels and Pterygium after Control for Sunlight Exposure

Evaluation of 25-Hydroxyvitamin D levels in patients with dermatochalasis

PURPOSE

To compare serum 25-hydroxyvitamin D (25(OH)D) levels of patients with dermatochalasis who underwent upper lid blepharoplasty and healthy controls.

METHODS

This retrospective comparative study included dermatochalasis patients who underwent upper lid blepharoplasty and age-and sex-matched controls from January 2019 to January 2021. The data, including comprehensive ophthalmological examination, internal medicine outpatient examination, and laboratory results of the dermatochalasis patients and healthy controls, were collected from the electronic patient records. Serum 25(OH)D, creatinine, calcium (Ca), phosphate (P), triglyceride (TG), low-density lipoprotein (LDL), and high-density lipoprotein (HDL) levels were evaluated and compared between the dermatochalasis patients and healthy controls.

RESULT

Of our participants, consisting of 46 patients with dermatochalasis and 52 healthy controls, 54 (55.10%) were female and 44 (44.90%) were male. A statistically significant difference was observed in vitamin D levels between the healthy and dermatochalasis groups (p ≤ 0.001). The percentage of individuals with vitamin D deficiency (< 20 ng/mL) was significantly higher in the dermatochalasis group (p = 0.001). In addition, the percentage of individuals with severe vitamin D deficiency (< 10 ng/mL) was again significantly higher in the dermatochalasis group (p = 0.001). The risk of dermatochalasis incidence was found to increase in cases of low vitamin D (OR = 1.210; p = 0.017).

CONCLUSION

Low serum 25(OH)D levels may play a role in the etiopathogenesis of dermatochalasis. Future research should include longitudinal studies and prospective clinical studies to investigate the mechanism responsible for the low vitamin D observed in dermatochalasis patients.

Vitamin D, the Vitamin D Receptor, Calcitriol Analogues and Their Link with Ocular Diseases

The global prevalence of eye diseases continues to grow, bringing with it a reduction in the activity levels and quality of life of patients, and partial or complete blindness if left untreated. As such, there is considerable interest in identifying more effective therapeutic options and preventive agents. One such agent is vitamin D, known to have a range of anti-cancer, anti-angiogenic, anti-inflammatory and anti-oxidative properties, and whose deficiency is linked to the pathogenesis of a range of cardiovascular, cancer, and inflammatory diseases. This review presents the current stage of knowledge concerning the link between vitamin D and its receptor and the occurrence of eye disease, as well as the influence of analogues of calcitriol, an active metabolite of vitamin D. Generally, patients affected by various ocular disorders have vitamin D deficiency. In addition, previous findings suggest that vitamin D modulates the course of eye diseases and may serve as a marker, and that its supplementation could mitigate some disorders. However, as these studies have some limitations, we recommend further randomized trials to clarify the link between vitamin D and its activity with eye disease.

High HDL-C and high LDL-C are risk factors of pterygium in a population-based cross-sectional study in Southern China: the Dongguan Eye Study

OBJECTIVES

To investigate the relationship between serum lipids and pterygium in a large-scale rural population aged 40 years or older from Southern China.

STUDY DESIGN

The Dongguan Eye Study was a cross-sectional population-based study from September 2011 to February 2012.

SETTING

The area was set in the rural area of Dongguan, Southern China.

PARTICIPANTS

Adult rural population aged 40 or older.

METHODS

Participants underwent physical, haematological and ophthalmic examinations.

PRIMARY AND SECONDARY OUTCOME MEASURES

The frequency and risk factors of pterygium.

RESULTS

A total of 11 357 participants were eligible for inclusion and 8952 (78.8%) participants were enrolled for the systemic and ophthalmic examinations. The prevalence of pterygium was 17.3% after adjusting the sex and age distribution, 22.0% in participants with hypercholesterolaemia (total cholesterol ≥6.22 mmol/L (240 mg/dL)) and 21.8% in those with low-density lipoprotein-cholesterol (LDL-C) ≥4.14 mmol/L (160 mg/dL), respectively. After adjusting for multiple confounding factors, higher level of high-density lipoprotein-cholesterol (HDL-C) (OR: 1.23, 95% CI: 1.06 to 1.41) and LDL-C (OR: 1.13, 95% CI: 1.06 to 1.20) were positively associated with the risk of pterygium. The ORs for HDL-C or LDL-C with pterygium were significantly greater in participants aged 40-49 years than those aged 50 years or above (P for interaction <0.001). Furthermore, increased HDL-C showed greater association with pterygium in normal body mass index (BMI) group compared with overweight group (P for interaction=0.002).

CONCLUSION

Increased HDL-C and LDL-C are risk factors of pterygium, especially in people <50 years or those with normal BMI level. Strict control of HDL-C and LDL-C may be a new prevention method in reducing the risk of pterygium.

Vitamin D and Ocular Diseases: A Systematic Review

The contributory roles of vitamin D in ocular and visual health have long been discussed, with numerous studies pointing to the adverse effects of vitamin D deficiency. In this paper, we provide a systematic review of recent findings on the association between vitamin D and different ocular diseases, including myopia, age-related macular degeneration (AMD), glaucoma, diabetic retinopathy (DR), dry eye syndrome (DES), thyroid eye disease (TED), uveitis, retinoblastoma (RB), cataract, and others, from epidemiological, clinical and basic studies, and briefly discuss vitamin D metabolism in the eye. We searched two research databases for articles examining the association between vitamin D deficiency and different ocular diseases. One hundred and sixty-two studies were found. There is evidence on the association between vitamin D and myopia, AMD, DR, and DES. Overall, 17 out of 27 studies reported an association between vitamin D and AMD, while 48 out of 54 studies reported that vitamin D was associated with DR, and 25 out of 27 studies reported an association between vitamin D and DES. However, the available evidence for the association with other ocular diseases, such as glaucoma, TED, and RB, remains limited.

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

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.

Comparison of vitamin D levels between patients with pterygium and healthy subjects

PURPOSE

The purpose of this study was to compare vitamin D (VD) deficiency frequency among patients with pterygium to that of healthy subjects and to investigate the VD deficiency among patients with pterygium.

METHODS

One-hundred eight pterygium patients and 94 healthy subjects were included in the study. Blood samples were collected from groups during the same time interval and the samples were saved. Serum 25-hydroxyvitamin D (25(OH)D) and parathormone (PTH) levels were measured and analyzed.

RESULTS

The pterygium group consisted of 57 female and 51 male patients, while the control group consisted of 47 female and 47 male patients. The mean age, sex and mean BMI were similar in the two groups (p > 0.05). The percentage of time that individuals spent outdoors was higher in the pterygium group (p = 0.02). The percentage of VD deficiency was 83.3% in the pterygium group and 61.7% in the control group (p = 0.001). There was a positive correlation between VD and time spent outdoors (p < 0.05).

CONCLUSIONS

VD deficiency can play a role in pterygium etiopathogenesis. Wide population-based studies in different regions are needed to evaluate this result.

Tear Fluid and Serum Vitamin D Concentrations in Unilateral Pterygium

SIGNIFICANCE

Vitamin D has antiangiogenic, anti-inflammatory, and antifibrotic properties, which may play an inhibitory role on pterygium formation. Vitamin D concentration was measured in few studies, and contradictory results have been reported. There is no study investigating tear fluid concentration of vitamin D in pterygium patients.

PURPOSE

This study evaluated tear fluid and serum vitamin D concentrations of pterygium patients in comparison with healthy controls.

METHODS

Thirty-five (21 male, 14 female) patients with unilateral pterygium and 25 (18 male, 7 female) healthy controls were included in this case-control study. After full ophthalmic examination, blood samples were taken, and basal tear fluid was collected using glass microcapillary tubes. Tear fluid and serum vitamin D concentrations were analyzed using enzyme-linked immunosorbent assay and analyzed statistically.

RESULTS

The mean ± standard deviation age of patients was 51.7 ± 16.7 years in the study group and 50.6 ± 18.7 years in the control group, respectively (P = .82). The mean tear fluid vitamin D concentration was statistically significantly higher than the mean serum concentration in the study groups (P < .0001). The mean tear fluid (P = .76) and serum vitamin D concentrations (P = .53) did not reveal statistically significant difference between patients and controls. There was no statistically significant difference for tear fluid vitamin D concentration between pterygium eyes and fellow eyes (P = .93). The difference in concentrations was compared within the pterygium subgroups, and it was found that the mean serum vitamin D concentration trended toward lower values as the stage of pterygium increased, and the mean tear fluid vitamin D concentration trended toward higher values as the stage of pterygium increased, although these differences were not statistically significant (all, P > .05).

CONCLUSIONS

Tear fluid and serum vitamin D concentrations do not seem to have a role in pterygium pathogenesis.

Evaluation of socioeconomic status as a risk factor of pterygium using the Korean National Health and Nutrition Examination Survey 2010 to 2011: A STROBE-compliant article

Pterygium is a common conjunctival disorder. The socioeconomic risk factors of pterygium have not been systematically evaluated in Korea. The study investigated risk factors of pterygium considering socioeconomic status.Participants were 9839 adults aged 19 to 74 years, who underwent ophthalmic slit-lamp examinations as part of the Korean National Health and Nutrition Examination Survey 2010 to 2011. Pterygium was diagnosed as a growth of fibrovascular tissue over the cornea. The socioeconomic risk factors were analyzed in association with the presence of pterygium. Multiple logistic regression analysis was used to evaluate the odds ratios for differences in socioeconomic status.The presence of pterygium was associated with diabetes mellitus, hypertension, metabolic syndrome, and sun exposure time (>5 h/d). The blood level of 25-hydroxyvitamin D was higher in the pterygium group than in the control group, but both groups were deficient in 25-hydroxyvitamin D compared with the normal reference level. Pterygium was almost 3 times as frequent among persons who worked outdoors, such as skilled agricultural, forestry, and fishery workers, than among those who worked indoors (odds ratio 3.061, 95% confidence interval 1.946-4.813). Low educational status and longer working hours were also significantly associated with pterygium.This study used a nationwide population-based survey conducted by the Korean Centers for Disease Control and Prevention to reveal that pterygium is associated with low socioeconomic status. Efforts should be made to reduce the risk of pterygium by changing modifiable risk factors, especially among people with low socioeconomic status.