Association Between Vitamin D Deficiency and Systemic Outcomes in Patients with Glaucoma: A Real-World Cohort Study

Area of Science:

• Ophthalmology
• Endocrinology
• Nephrology
• Cardiology

Background:

• Glaucoma, an optic neuropathy, often co-occurs with systemic diseases.
• Vitamin D deficiency (VDD) is linked to cardiovascular and renal diseases, but its role in glaucoma outcomes is unknown.

Purpose of the Study:

• To investigate the association between baseline vitamin D status and long-term systemic outcomes in primary glaucoma patients.
• To evaluate the impact of VDD on mortality and cardiorenal events in this population.

Main Methods:

• Retrospective cohort study using electronic health records (TriNetX U.S. Collaborative Network).
• Included adults (≥18 years) with primary glaucoma and serum 25-hydroxyvitamin D (25(OH)D) levels.
• Propensity score matching (1:1) for 11,855 patients with VDD (<30 ng/mL) vs. vitamin D adequacy (VDA; ≥30 ng/mL).
• Follow-up for up to 5 years assessing all-cause mortality, MACE, AKI, and renal function decline.

Main Results:

• VDD was associated with significantly higher 5-year risks of all-cause mortality (HR 1.104), MACE (HR 1.151), and AKI (HR 1.154).
• No significant difference in renal function decline risk was observed between VDD and VDA groups (HR 0.972).
• Risk differences emerged within the first year and persisted over the 5-year follow-up.

Conclusions:

• Vitamin D deficiency in primary glaucoma patients correlates with elevated long-term risks of mortality and cardiorenal complications.
• VDD was not associated with renal function decline in this cohort.
• Vitamin D status may serve as an indicator of broader systemic vulnerability in glaucoma.