Circulating vitamin D concentration and age-related macular degeneration: Systematic review and meta-analysis.
Vitamin D may be involved in ocular function in older adults, but there is no current consensus on a possible association between circulating concentrations of 25-hydroxyvitamin D (25OHD) and the occurrence of age-related macular degeneration (AMD). Our objective was to systematically review and quantitatively assess the association of circulating 25OHD concentration with AMD. A Medline search was conducted in November 2015, with no date limit, using the MeSH terms "Vitamin D" OR "Vitamin D deficiency" OR "Ergocalciferols" OR 'Cholecalciferol' combined with "Age-related macular degeneration" OR "Macular degeneration" OR "Retinal degeneration" OR "Macula lutea" OR "Retina". Fixed and random-effects meta-analyses were performed to compute (i) standard mean difference in 25OHD concentration between AMD and non-AMD patients; (ii) AMD risk according to circulating 25OHD concentration. Of the 243 retrieved studies, 11 observational studies-10 cross-sectional studies and 1 cohort study-met the selection criteria. The number of participants ranged from 65 to 17,045 (52-100% women), and the number with AMD ranged from 31 to 1440. Circulating 25OHD concentration was 15% lower in AMD compared with non-AMD on average. AMD was inversely associated with the highest 25OHD quintile compared with the lowest (summary odds ratio (OR)=0.83 [95%CI:0.71-0.97]), notably late AMD (summary OR=0.47 [95%CI:0.28-0.79]). Circulating 25OHD<50nmol/L was also associated with late-stage AMD (summary OR=2.18 [95%CI:1.34-3.56]), an association that did not persist when all categories of AMD were considered (summary OR=1.26 [95%CI:0.90-1.76]). In conclusion, this meta-analysis provides evidence that high 25OHD concentrations may be protective against AMD, and that 25OHD concentrations below 50nmol/L are associated with late AMD.
Department of Neuroscience, Division of Geriatric Medicine and Memory Clinic, Angers University Hospital, UPRES EA 4638, University of Angers, LUNAM, Angers, France; Robarts Research Institute, Department of Medical Biophysics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, Ontario, Canada. Electronic address: CeAnnweiler@chu-angers.fr.
Cedric
C
Annweiler
Department of Neuroscience, Division of Ophthalmology, Angers University Hospital, Angers, France.
Morgane
M
Drouet
Department of Neuroscience, Division of Geriatric Medicine and Memory Clinic, Angers University Hospital, UPRES EA 4638, University of Angers, LUNAM, Angers, France.
Guillaume T
GT
Duval
Department of Neuroscience, Division of Geriatric Medicine and Memory Clinic, Angers University Hospital, UPRES EA 4638, University of Angers, LUNAM, Angers, France.
Pierre-Yves
PY
Paré
Department of Neuroscience, Division of Ophthalmology, Angers University Hospital, Angers, France.
Stephanie
S
Leruez
Université d'Angers, Laboratoire Angevin de Recherche en Ingénierie des Systèmes (LARIS)-EA7315, LUNAM, Université d'Angers, Angers F-49000, France; Département de Médecine Physique et de Réadaptation, CHU, Angers F-49933, France.
Mickael
M
Dinomais
Department of Neuroscience, Division of Ophthalmology, Angers University Hospital, Angers, France; Singapore Eye Research Institute, Singapore, Singapore; Singapore National Eye Centre, Singapore, Singapore; Duke-NUS, Neuroscience and Behavioural Disorders, Singapore, Singapore.
Dan
D
Milea
D003430:Cross-Sectional Studies; D006801:Humans; D008268:Macular Degeneration / Q000097:blood / Q000150:complications*; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D014808:Vitamin D Deficiency / Q000097:blood / Q000150:complications*
D014807:Vitamin D; C104450:25-hydroxyvitamin D
Age-related macular degeneration; Eye; Meta-analysis; Neuroendocrinology; Older adults; Vitamin D