Abstract

Aim: This study is to investigate the association between the patients with dry eye syndrome and serum vitamin D level in hospital-based population.

Study Design: Prospective, cross-sectional study.

Methods: 88 participants (including male and female) diagnosed with Dry Eye Syndrome having no ocular diseases or any auto-immune systemic diseases were included. Comprehensive eye examination was done for all subjects. OSDI questionnaire, Schirmer’s Test I and II and Tear Break up Time (TBUT) along with the measurement of Serum vitamin D level were performed for all the subjects. Analyses were made using the SPSS.

Results: The mean age of the participants was 37.67 ± 14.17 years (95% CI: 34.92-40.65). Mean ST-I was found to be 8.54 ± 3.43mm (95% CI: 34.92-40.65), mean OSDI score was 45.80 ± 9.74 (95% CI: 43.76-47.80), mean ST-II was 5.86 ± 2.92mm (95% CI: 5.30-6.34), mean TBUT was 5.98 ± 2.23 seconds (95% CI: 5.47-6.47) and Serum Vit-D level was 20.21 ± 9.24 ng/ml (95% CI: 18.06-21.98). Statistically significant difference was observed between ST-I and ST-II (P ˂ 0.001). Regression analysis showed a significant association for OSDI (r = 0.938, p ˂ 0.001), ST-II (r = 0.28, p ˂ 0.04) and TBUT (r = 0.64, p ˂ 0.001) with Serum Vit-D level.

Conclusion: In our study, OSDI score, low tear secretion level and tear break up time suggested to show significantly low Serum Vitamin-D concentration in blood which may be the contributory factor for DES. The results of the study suggest that serum Vit-D supplementation can be a useful and effective treatment of DES.

Keywords: Cross Sectional Study; OSDI Questionnaire; Dry Eye Syndrome; Tear Secretion; Serum 25 Hydroxyvitamin-D Level

References

1. Brad Bowling. Kanski’s Clinical ophthalmology (8thed.). Elsevier Limited (2016).
2. Schaumberg DA., et al. “Prevalence of dry eye syndrome among US women”. American Journal of Ophthalmology 136 (2003): 318-326.
3. N Gupta., et al. “Estimating the prevalence of dry eye among Indian patients attending a tertiary ophthalmology clinic”. Annals of Tropical Medicine and Parasitology3 (2010): 247-255.
4. Research in dry eye: report of the Research Subcommittee of the International Dry Eye Work Shop (2007).
5. Schiffman RM., et al. “Reliability and validity of the ocular surface disease index”. Archives of Ophthalmology 118 (2000): 615-621.
6. Mencucci R., et al. “Effect of a hyaluronic acid and carboxymethylcellulose ophthalmic solution on ocular comfort and tear-film instability after cataract surgery”. Journal of Cataract and Refractive Surgery 41 (2015): 1699-1704.
7. DeLuca HF. “Overview of general physiologic features and functions of vitamin D”. The American Journal of Clinical Nutrition 80 (2004): 1689S-1696S.
8. Kurtul B E., et al. “The association of vitamin D deficiency with tear break-up time and Schirmer testing in non-Sjögrendry eye”. Eye (Lond) 29 (2015): 1081-1084.
9. Seok Hyun Bae., et al. “Vitamin D Supplementation for Patients with Dry Eye Syndrome Refractory to Conventional Treatment”. Scientific Reports 6 (2016): 33083.
10. Cem Cankaya., et al. “Corneal endothelial changes in patients with vitamin D deficiency”. 66.9 (2018).
11. Shetty R., et al. “Bowman break and subbasal nerve plexus changes in a patient with dry eye presenting with chronic ocular pain and Vitamin D deficiency”. Cornea 35 (2016): 688-691.
12. Alsalem JA., et al. “Characterization of Vitamin D production by human ocular barrier cells”. Investigative Ophthalmology and Visual Science 55 (2014): 2140-2147.
13. Tovey A and Cannell J. “New study suggests vitamin D deficiency is related to dry eye”. The Vitamin D Council Blog and Newsletter (2015).
14. Adam T., et al. “The Wills Eye Manual”. LIPPINCOTT WILLIAMS and WILKINS (2012).
15. Adam T., et al. “The Wills Eye Manual”. LIPPINCOTT WILLIAMS and WILKINS (2012).
16. Parvin Dibajnia., et al. “Tear Film Break-up Time in Bipolar Disorder”. Iranian Journal of Psychiatry4 (2012): 191-193.
17. Institute of Medicine of the National Academies. Dietary reference intakes for calcium and vitamin D. Washington, DC: The National Academies Press (2010).
18. Kurtul B E., et al. “The association of vitamin D deficiency with tear break-up time and Schirmer testing in non-Sjögrendry eye”. Eye (Lond) 29 (2015): 1081-1084.
19. Yildirim P., et al. “Dry eye in vitamin D deficiency: more than an incidental association”. International Journal of Rheumatic Diseases (2015).
20. Yi-Fang, Meng Jiong., et al. “Lower Serum Vitamin D Level Was Associated with Risk of Dry Eye Syndrome”. Department of Ophthalmology, Changshu No. 2 People’s Hospital, Changshu, Jiangsu, P.R. China (2017).
21. BE Kurtul., et al. “The association of vitamin D deficiency with tear break-up time and Schirmer testing in non-Sjögren dry eye”. Eye 29 (2015): 1081-1084.
22. Anshu Sahai., et al. “Dry Eye: Prevalence and Attributable Risk Factors in a Hospital-Based Population”. Indian Journal of R Ophthalmology 53 (2005): 87-91.
23. Hwang JS., et al. “Vitamin D Enhances the Efficacy of Topical Artificial Tears in Patients With Dry Eye Disease”. Cornea3 (2019): 304-310.
24. Kizilgul M., et al. “Vitamin D Replacement Improves Tear Osmolarity in Patients with Vitamin D Deficiency”. Seminar on Ophthalmology5 (2018): 589-594.
25. Kim MJ., et al. “Association Between Serum 25-Hydroxyvitamin D Levels and Dry Eye in Korean Adults: A Study Based on Korean National Health and Nutrition Examination Survey, 2010-2011”. Korean Journal of Family Medicine 2 (2017): 81-85.
26. Jin KW., et al. “Correlation of vitamin D levels with tear film stability and secretion in patients with dry eye syndrome”. Acta Ophthalmology3 (2017): e230-e235.
27. Da-Hye Jeon., et al. “Serum Vitamin D Levels Associated With Dry Eye Disease Results From the Study Group for Environmental Eye Disease”. Journal of Preventive Medicine and Public Health 6 (2017): 369-376.
28. Yang CH., et al. “Impact of oral vitamin D supplementation on the ocular surface in people with dry eye and/or low serum vitamin D”. Contact Lens and Anterior Eye 1 (2018): 69-76.
29. https://www.eyedocs.co.uk/ophthalmology-articles/cornea/505-schirmers-test
30. Donghyun Jee., et al. “Serum 25-Hydroxyvitamin D Levels and Dry Eye Syndrome: Differential Effects of Vitamin D on Ocular Diseases”. Plos One2 (2016).
31. Erstappen A., et al. “Vitamin D-dependent calcium binding protein immunoreactivity in human retina”. Ophthalmic Research 18 (1986): 209-214.
32. Johnson JA., et al. “Immuno-localization of the calcitriol receptor, calbindin-D28k and the plasma membrane calcium pump in the human eye”. Current Eye Research 14 (1995): 101-108.

Citation

Citation: Prasenjit Saha., et al. “Association Between Serum Vitamin-D Level and Dry Eye Syndrome - A prospective Cross-sectional Study".Acta Scientific Ophthalmology 4.2 (2021): 45-55.

Copyright

Copyright: © 2021 Prasenjit Saha., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.