Relation between vitamin D deficiency and diabetic maculopathy.

Area of Science:

• Ophthalmology
• Endocrinology
• Nutritional Science

Background:

• Diabetic retinopathy (DR) progression is linked to vitamin D deficiency.
• The specific role of vitamin D in diabetic maculopathy is not fully understood.
• Diabetic macular edema (DME) affects visual acuity and is a complication of diabetes.

Purpose of the Study:

• To investigate the association between serum vitamin D levels and diabetic maculopathy.
• To evaluate the relationship between vitamin D and retinal microvascular parameters in patients with DME.

Main Methods:

• Cross-sectional study of 68 patients with DME.
• Ophthalmic examinations including Optical Coherence Tomography Angiography (OCTA).
• Assessment of superficial and deep vascular density and foveal avascular zone (FAZ) using OCTA.
• Measurement of serum vitamin D levels.
• Exclusion of patients with renal impairment, granulomatous diseases, or vitamin D supplementation.

Main Results:

• Serum vitamin D levels positively correlated with superficial and deep vascular density in all retinal zones (foveal, parafoveal, perifoveal).
• Vitamin D levels negatively correlated with FAZ in both superficial and deep retinal layers.
• Multivariate analysis confirmed vitamin D as a significant predictor of vascular density and FAZ, independent of age, gender, and diabetes duration.

Conclusions:

• Diabetic macular ischemia, characterized by reduced vascular density and enlarged FAZ, is closely associated with vitamin D deficiency.
• These findings suggest a potential role for vitamin D in preventing or mitigating retinal microvascular damage in diabetic retinopathy.