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Editors Selection IGR 18-2
Miscellaneous: Glaucoma and Vitamin D
Comment by Radha Ayyagari on:
70768 The Relationship between Vitamin D and Glaucoma: A Kangbuk Samsung Health Study, Kim HT; Kim JM; Kim JH et al., Korean Journal of Ophthalmology, 2016; 30: 426-433
Vitamin D has gained attention as a potential modifiable risk factor for multiple pathologies. An association between vitamin-D levels and diseases such as glaucoma, diabetes, thyroiditis, cancer, metabolic syndrome, renal disease, multiple sclerosis, hypertension, polycystic ovarian syndrome and hypogonadism has been reported. Specifically an association between vitamin-D levels and risk for glaucoma has been observed in multiple populations.
The current study by Kim et al. reports an association between lower vitamin-D levels and elevated risk for glaucoma in females in a Korean population. A total of 123,221 subjects of the Kangbuk Samsung health study were analyzed. Among these, 1,627 were diagnosed with glaucoma based on the International Society of Geographical and Epidemiological Ophthalmology (ISGEO) criteria or RNFL defect. Levels of serum 25-hydroxyvitamin D [25(OH)D] were measured and quintiles were generated. After adjusting for sex, the prevalence of glaucoma was found to be not significantly different between the 25(OH)D quintiles. However, the multivariable-adjusted logistic analysis showed the odds ratio of glaucoma for the fourth quintile was significantly lower than that of the first quintile in females. As the authors acknowledged, smaller sample size is a limitation in this study. In addition lack of detailed phenotype data limits the ability to compare finding with other published studies.
An association between vitamin-D levels and risk for glaucoma has been observed in multiple populations
The specific role of vitamin D on development of glaucoma is not well understood. However, polymorphisms in vitamin D receptor gene have shown an association with susceptibility to glaucoma, further supporting a possible role for vitamin D in glaucoma pathology. The majority of studies that were carried out to test the association between serum 25-hydroxyvitamin-D levels and glaucoma were performed on small cohorts. In addition, the definition of glaucoma used in these studies is not uniform. Therefore, analysis of a larger cohort with detailed phenotype evaluation might provide conclusive data and enable an assessment on the potential role of vitamin D as a risk factor of glaucoma. Identification of modifiable risk factors for glaucoma will be highly valuable for developing therapies to prevent or treat glaucoma.
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