ROLE OF VITAMIN D IN ENDOTHELIAL CELL OF RETINA

Abstract

Vitamin D deficiency is a common health problem worldwide. Many parts of the human eye, including the epithelium of the cornea, lens, ciliary body, and retinal pigment epithelium, as well as the corneal endothelium, ganglion cell layer, and retinal photoreceptors, contain vitamin D receptor. Physiological effects of vitamin D From an ocular point of view, the role in macular and retinal health had been advanced, as well as the involvement in corneal inflammatory response, wound healing, and dry eye disease. The most important effect of vitamin D is on, phosphorus, calcium metabolism and on bone mineralization. Recently, it was observed that vitamin D deficiency and insufficiency are related with common cancers, cardiovascular diseases, metabolic syndromes, infectious, and many chronic diseases including autoimmune disease. Benefits of vitamin D may be amplified through synergistic interaction with topical corticosteroids which accelerates improvement in corneal shape and optics, substantially benefiting the control of ocular surface disease and dry eye symptoms. Aqueous humour is the primary source responsible for the feeding of corneal endothelial layer hence endothelial abnormalities can be expected due to accumulated inflammatory cytokines and multiple toxic products in the aqueous humour of the patients with vitamin D deficiency.
 MATERIAL AND METHODS: Subjects were selected with vitamin D deficiency in the age group of 20–55 years. 50 patients having serum vitamin D levels <15 ng/ml were included in the study. Serum vitamin D levels of <15 ng/ml were included in the control group. Vitamin D levels in tear fluid were measured by direct competitive chemiluminescent enzyme linked immunoassay. A complete ophthalmic evaluation was performed in all participants which includes assessment of visual acuity, anterior segment evaluation and posterior segment evaluation. Specular microscopy was performed on the eyes of the patients with vitamin D deficiency and healthy control group individuals. Corneal endothelial cell density (CD) and central corneal thickness (CCT) values were calculated automatically using the software of the specular microscope. 
 RESULTS: The study group included 23 male and 27 female subjects while study group included 24 male and 26 female. Mean age of male in study group was 46.4 ± 12.56 and female was 45.6 ± 11.77. In control group mean male age was 48.5 ± 9.25 and female age was 49.56 ± 12.55. In study group Mean Corneal endothelial cell density (CD) was observed as 2632.89 ± 189.25 cells/mm 2 and Mean central corneal thickness (CCT) was 587.2 ± 25.89 μ. In control group Mean Corneal endothelial cell density (CD) was observed as 2954.97 ± 116.89 cells/mm 2 and Mean central corneal thickness (CCT) was 546.0 ± 36.22 μ. Vitamin D levels of Tears in study group was 8.4 ± 1.7 ng/ml and in control group it was 16.2 ± 2.3 ng/ml.
 CONCLUSION: It has been observed that there is statistically significant difference in the corneal endothelial cell density (CD) and central corneal thickness (CCT) in patients with vitamin D deficiency. It was observed that Vitamin D is present in tear fluid and there is significant difference in the levels of vitamin D in study and control group.