Association of Low Vitamin D with Infectious and Non-Infectious Inflammatory Ocular Disease

To validate the previously established association between vitamin D levels and non-infectious ocular inflammatory diseases and to assess for a potential relationship between vitamin D levels and subtypes of infectious ocular inflammation.

This retrospective case-control study identified 1468 cases and 490 controls with a measured serum 25-hydroxy vitamin level. Cases included patients diagnosed with infectious or noninfectious ocular inflammation while controls had a normal eye exam. The primary outcome was the odds of ocular inflammatory disease in participants with normal versus low serum vitamin D levels. Separate sub-analyses for vitamin D levels in individual types of infectious inflammation (endophthalmitis, orbital cellulitis, herpetic keratitis, other infectious keratitis, other infectious causes) and noninfectious ocular inflammation were performed.

Cases had significantly lower serum vitamin D levels than controls (29 ± 12.7 vs 33 ± 12.7 nanograms per milliliter (p < 0.001)). In multivariate regression analysis, the odds of having infectious or non-infectious ocular inflammation were 2.7 times higher in patients with hypovitaminosis D compared to those with normal vitamin D levels [Odds ratio (OR) = 2.74, 95% Confidence interval (CI) = 2.19-3.44, p < 0.001)]. The odds of developing infectious or non-infectious inflammation decreased by 3% for every unit increase in vitamin D level (OR = 0.97, 95% CI = 0.97-0.98, p < 0.001). Low vitamin D levels were significantly associated with non-infectious intraocular inflammation (p < 0.001) and with all included subtypes of infectious ocular inflammation (p ≤ 0.001).

Low vitamin D is associated with increased risk of infectious and non-infectious ocular inflammation in a retrospective study.