Abstract
ObjectivesTo evaluate potential differences in plasma 25-hydroxyvitamin in subtypes of age-related macular degeneration (AMD), and in patients in Clinical Age-Related Maculopathy Staging (CARMS) group 5 with or without subretinal fibrosis.MethodsThis single-center cross-sectional study included 178 participants during a period of 20 months. Ninety-five patients belonged to CARMS 5; twelve belonged to CARMS 4; twenty-two belonged to CARMS 2 or 3; and 49 individuals did not have AMD (CARMS 1). Following a structured interview, a detailed bilateral retinal examination was performed and participants were allocated to their respective subgroups in accordance with the Clinical Age-Related Maculopathy Staging system. Plasma 25-hydroxyvitamin D2 and D3 were analyzed using liquid chromatography-tandem mass spectrometry. Genomic DNA was extracted from leukocytes and genotyped for single nucleotide polymorphisms (SNPs) in the vitamin D metabolism. Differences in plasma 25-hydroxyvitamin D were determined in the subgroups as well as between patients in CARMS 5 with or without subretinal fibrosis.ResultsPlasma 25-hydroxyvitamin D was comparable in patients across CARMS groups 1 to 5 (p = 0.83). In CARMS 5, the presence of subretinal fibrosis was associated with significantly lower concentrations of 25-hydroxyvitamin D as compared to the absence of subretinal fibrosis (47.2 versus 75.6 nmol/L, p<0.001). Patients in CARMS 5 with subretinal fibrosis were more likely to have insufficient levels of 25-hydroxyvitamin D compared to patients without subretinal fibrosis (p = 0.006). No association was found between the SNPs rs10877012, rs2228570, rs4588, or rs7041 and AMD subgroups or plasma 25-hydroxyvitamin levels.ConclusionsThis study suggests that the presence of subretinal fibrosis in patients belonging to CARMS 5 may be associated with a poor vitamin D status. Our observations warrant further investigation into the role of vitamin D in the development of subretinal fibrosis.
Highlights
Age-related macular degeneration (AMD) is the leading cause of visual impairment in elders over 60 years of age [1,2,3,4]
When patients in Clinical Age-Related Maculopathy Staging (CARMS) 5 were subdivided depending on whether or not subretinal fibrosis was observed, there was a significant difference in 25-hydroxyvitamin D concentrations (75.6 nmol/L if subretinal fibrosis was absent vs. 47.2 nmol/L if subretinal fibrosis was present (p,0.001, Student’s independent t-test) (Figure 2))
Patients in CARMS 5 without subretinal fibrosis were more likely to have 25hydroxyvitamin D concentrations above 50 nmol/L compared to patients with subretinal fibrosis, who were more likely to have vitamin D deficiency (p = 0.006, Chi-square test)
Summary
Age-related macular degeneration (AMD) is the leading cause of visual impairment in elders over 60 years of age [1,2,3,4]. Atrophy and/or choroidal neovascularization (CNV) with or without subretinal fibrosis may develop resulting in significant loss of central vision. While the vascular component of CNV often responds to treatment with intravitreal anti-vascular growth factor compounds (anti-VEGF), the fibrous tissue component of CNV mostly appears not to do so and often increases in prominence after treatment, with associated irreversible damage to the retinal architecture and severe vision loss. Oxidative stress and alterations in the immune system appear to be critical factors in the development of AMD [7,8]. Dysregulation of the immune system favors an environment consisting of chronic inflammation, angiogenesis, and fibrosis
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
