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Review article| Volume 88, P101-112, June 2016

Circulating vitamin D concentration and age-related macular degeneration: Systematic review and meta-analysis

  • Cedric Annweiler
    Correspondence
    Corresponding author at: Department of Neuroscience, Division of Geriatric Medicine, Angers University Hospital, 49933 Angers Cedex 9, France.
    Affiliations
    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
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  • Morgane Drouet
    Affiliations
    Department of Neuroscience, Division of Ophthalmology, Angers University Hospital, Angers, France
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  • Guillaume T Duval
    Affiliations
    Department of Neuroscience, Division of Geriatric Medicine and Memory Clinic, Angers University Hospital, UPRES EA 4638, University of Angers, LUNAM, Angers, France
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  • Pierre-Yves Paré
    Affiliations
    Department of Neuroscience, Division of Geriatric Medicine and Memory Clinic, Angers University Hospital, UPRES EA 4638, University of Angers, LUNAM, Angers, France
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  • Stephanie Leruez
    Affiliations
    Department of Neuroscience, Division of Ophthalmology, Angers University Hospital, Angers, France
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  • Mickael Dinomais
    Affiliations
    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
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  • Dan Milea
    Affiliations
    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
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      Highlights

      • 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.

      Abstract

      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.

      Keywords

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