- •Vitamin D may be involved in ocular health and function.
- •High concentrations 25-hydroxyvitamin D are associated with less age-related macular degeneration.
- •Concentrations of 25-hydroxyvitamin D under 50 nmol/L are associated with late-stage age-related macular degeneration.
- •These findings provide a scientific basis for vitamin D replacement trials.
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 < 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.
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Published online: April 02, 2016
Accepted: April 1, 2016
Received: March 21, 2016
© 2016 Elsevier Ireland Ltd. All rights reserved.