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April 11, 2011

Vitamin D Status and Early Age-Related Macular Degeneration in Postmenopausal Women

Author Affiliations

Author Affiliations: Department of Social and Preventive Medicine, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York (Dr Millen); Department of Ophthalmology and Visual Sciences (Drs Voland and Mares and Ms Sondel), Department of Biostatistics and Medical Informatics, School of Medicine and Public Health, Clinical Science Center (Dr Chappell), and Department of Obstetrics and Gynecology, School of Medicine and Public Health (Dr Sarto), University of Wisconsin, Madison; Department of Nutrition, Food Studies and Public Health, New York University, New York (Dr Parekh); Department of Animal Science, Iowa State University, Ames (Dr Horst); Department of Epidemiology, General Hospital Office, University of Iowa, Iowa City (Dr Wallace); Translational Research Institute, John A. Moran Eye Center, University of Utah, Salt Lake City (Dr Hageman); Fundus Photograph Reading Center, Madison, Wisconsin (Dr Blodi); Department of Ophthalmology, Oregon Health and Science University/Casey Eye Institute, Portland (Dr Klein); and the Center for Retina and Macular Disease, Winter Haven, Florida (Dr Gehrs).



Arch Ophthalmol. 2011;129(4):481-489. doi:10.1001/archophthalmol.2011.48

Objective  The relationship between serum 25-hydroxyvitamin D (25[OH]D) concentrations (nmol/L) and the prevalence of early age-related macular degeneration (AMD) was investigated in participants of the Carotenoids in Age-Related Eye Disease Study.

Methods  Stereoscopic fundus photographs, taken from 2001 to 2004, assessed AMD status. Baseline (1994-1998) serum samples were available for 25(OH)D assays in 1313 women with complete ocular and risk factor data. Odds ratios (ORs) and 95% confidence intervals (CIs) for early AMD (n = 241) of 1287 without advanced disease were estimated with logistic regression and adjusted for age, smoking, iris pigmentation, family history of AMD, cardiovascular disease, diabetes, and hormone therapy use.

Results  In multivariate models, no significant relationship was observed between early AMD and 25(OH)D (OR for quintile 5 vs 1, 0.79; 95% CI, 0.50-1.24; P for trend = .47). A significant age interaction (P = .002) suggested selective mortality bias in women aged 75 years and older: serum 25(OH)D was associated with decreased odds of early AMD in women younger than 75 years (n = 968) and increased odds in women aged 75 years or older (n = 319) (OR for quintile 5 vs 1, 0.52; 95% CI, 0.29-0.91; P for trend = .02 and OR, 1.76; 95% CI, 0.77-4.13; P for trend = .05, respectively). Further adjustment for body mass index and recreational physical activity, predictors of 25(OH)D, attenuated the observed association in women younger than 75 years. Additionally, among women younger than 75 years, intake of vitamin D from foods and supplements was related to decreased odds of early AMD in multivariate models; no relationship was observed with self-reported time spent in direct sunlight.

Conclusions  High serum 25(OH)D concentrations may protect against early AMD in women younger than 75 years.