(10-12-2017) Circulating vitamin D concentration and age-related macular degeneration: Systematic review and meta-analysis
Cedric Annweilera,b,∗, Morgane Drouetc, Guillaume T Duvala, Pierre-Yves Paréa,
Stephanie Leruezc, Mickael Dinomaisd,e, Dan Mileac,f,g,h
a Department of Neuroscience, Division of Geriatric Medicine and Memory Clinic, Angers University Hospital, UPRES EA 4638, University of Angers, LUNAM,
Angers, France
b Robarts Research Institute, Department of Medical Biophysics, Schulich School of Medicine and Dentistry, The University of Western Ontario, London,
Ontario, Canada
c Department of Neuroscience, Division of Ophthalmology, Angers University Hospital, Angers, France
d Université d’Angers, Laboratoire Angevin de Recherche en Ingénierie des Systèmes (LARIS)—EA7315, LUNAM, Université d’Angers, Angers F-49000, France
e Département de Médecine Physique et de Réadaptation, CHU, Angers F-49933, France
f Singapore Eye Research Institute, Singapore, Singapore
g Singapore National Eye Centre, Singapore, Singapore
h Duke-NUS, Neuroscience and Behavioural Disorders, Singapore, Singapore
a r t i c l e i n f o
Article history:
Received 21 March 2016
Accepted 1 April 2016
Keywords:
Eye
Age-related macular degeneration
Meta-analysis
Neuroendocrinology
Vitamin D
Older adults
a b s t r a c t
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 deficiencyâ€
OR “Ergocalciferols†OR ‘Cholecalciferol’ combined with “Age-related macular degeneration†OR
“Macular degeneration†OR “Retinal degeneration†OR “Macula lutea†OR “Retinaâ€. Fixed and randomeffects
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 < 50 nmol/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
50 nmol/L are associated with late AMD.
Source: jo u r n al hom ep age: www.elsevier.com/locate/maturitas
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