Journal of The Korean Ophthalmological Society (대한안과학회지)

The Korean Ophthalmological Society (대한안과학회)
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Analysis of 25-Hydroxy Vitamin D in the Aqueous Humor of Age-related Macular Degeneration Patients

습성 연령관련황반변성 환자에서 안구 방수 내 비타민 D 분석

  • Song, Won Seok (Department of Ophthalmology, Hallym University Kangdong Sacred Heart Hospital) ;
  • Yoon, Won Tae (Goseong Public Health Center) ;
  • Kim, Yong-Kyu (Department of Ophthalmology, Hallym University Kangdong Sacred Heart Hospital) ;
  • Park, Sung Pyo (Department of Ophthalmology, Hallym University Kangdong Sacred Heart Hospital)
  • 송원석 (한림대학교 강동성심병원 안과학교실) ;
  • 윤원태 (고성군 보건소) ;
  • 김용규 (한림대학교 강동성심병원 안과학교실) ;
  • 박성표 (한림대학교 강동성심병원 안과학교실)
  • Received : 2018.07.05
  • Accepted : 2018.10.22
  • Published : 2018.11.15
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Abstract

Purpose: We examined aqueous humor levels of 25-hydroxyvitamin D (vitamin D) in patients with age-related macular degeneration to investigate possible relationships between aqueous humor vitamin D levels and clinical manifestations. Methods: Patients > 50 years of age, 52 eyes of 34 patients with age-related macular degeneration, and 23 eyes of 17 patients treated with cataract surgery without retinal disease, were examined for aqueous humor vitamin D levels and compared. The experimental group was divided into two groups according to the median value of aqueous humor vitamin D levels. We compared the clinical manifestations of macular degeneration in both groups and identified relationships between aqueous humor vitamin D levels and clinical features. Results: Vitamin D levels in the aqueous humor were significantly lower in the experimental group than in the control group (experimental, $10.03{\pm}10.1ng/mL$ vs. control group, $40.8{\pm}16.4ng/mL$; p < 0.001). Patients with high vitamin D levels in the macular degeneration group had a higher percentage of fibrovascular pigment epithelial detachments than those in the low grade group (high grade group, 65% vs. low grade group, 27%; p = 0.003). Multiple linear regression analysis showed a significant correlation between vitamin D levels and the total number of anti-vascular endothelial growth factor intravitreal injections within 6 months (standardize coefficient, ${\beta}=-0.336$). Conclusions: Patients with wet age-related macular degeneration had significantly lower vitamin D levels in the aqueous humor compared to control group subjects of similar ages. However, in patients with macular degeneration, low vitamin D levels were associated with a greater number of intravitreal injections, while higher levels of vitamin D may lead to more advanced forms of fibrovascular retinal pigment epithelium and related low vision. These relationships were not always constant, so further studies on the relationships between local vitamin D levels and ocular disorders are needed.

목적: 습성 연령관련황반변성 환자의 방수 내 비타민 D 농도를 측정하여, 체내 비타민 D 농도가 질병의 임상 양상과 어떠한 관련성을 보이는지 알아보고자 한다. 대상과 방법: 50세 이상의 습성 연령관련황반변성 환자 34명 52안과, 망막 질환이 없는 백내장수술 환자 17명 23안에서 안구 방수를 채취하여 비타민 D 농도를 측정하고 비교하였다. 환자군을 안구 방수 내 비타민 D 수치의 중간값을 기준으로 수치가 높은 군과 낮은군으로 나누어 황반변성과 관련된 여러 임상 양상과의 관련성을 살펴보았다. 결과: 황반변성군에서 대조군에 비해 안구 방수 내 비타민 D 농도가 유의하게 낮았다(황반변성군 $10.03{\pm}10.1ng/mL$ vs. 대조군 $40.8{\pm}16.4ng/mL$, p<0.001). 환자군 내에서 비타민 D 수치가 높은 군은 낮은 군에 비해 섬유혈관성 망막색소상피박리 유형의 비율이 높았다(높은 군 65% vs. 낮은 군 27%, p=0.003). 다중 선형 회귀 분석 결과 안구 방수 내 비타민 D 수치와 6개월 이내 총 주사 횟수와 유의한 관련성을 보였다(standardize coefficient ${\beta}=-0.336$). 결론: 습성 연령관련황반변성 환자는 대조군에 비해 안구 방수 내 비타민 D 수치가 유의하게 낮았다. 하지만 환자군 내에서는 비타민 D 수치가 낮을 시 더 많은 유리체강 내 주사치료 횟수와 관련되는 한편, 수치가 높은 경우 섬유혈관성 망막색소상피박리 및 더 낮은 시력과 관련을 보이는 등 관련성은 일정하지 않았다. 눈에서의 국소적인 비타민 D 수치와 질환과의 관련성에 대한 추가 연구가 필요하겠다.

Keywords

Acknowledgement

Supported by : Hallym University Kangdong Sacred Heart Hospital

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