ASSESSING THE IMPACT OF ORAL VITAMIN D SUPPLEMENTATION ON SERUM VITAMIN D LEVELS, DISEASE ACTIVITY, AND TEAR FILM IN GRAVES’ OPHTHALMOPATHY: A SYSTEMATIC REVIEW

Main Article Content

Andi Ayu Lestari
Junaedi Sirajuddin
Halimah Pagarra

Keywords

graves’ ophthalmopathy, opthalmology, Vitamin D, Treatment, Eye disease

Abstract

Background: Graves' Ophthalmopathy (GO) poses unique challenges in its management, prompting an exploration into potential interventions to address both systemic and ocular manifestations. This systematic review aims to assess the impact of oral vitamin D supplementation on critical parameters in GO, including serum vitamin D levels, disease activity, and tear film dynamics. 


Methods: A systematic review was performed by searching relevant studies until Desember 2023 using the PubMed, MEDLINE, and EMBASE databases. Studies involving individuals with GO and has oral vitamin D supplementation were included in this review.


Results: The synthesized findings reveal a consistent positive correlation between oral vitamin D supplementation and elevated serum vitamin D levels in individuals with GO. Notably, this correlation suggests a potential link influencing the autoimmune processes underlying GO. Moreover, our analysis highlights promising effects on disease activity markers and tear film parameters, indicating the multifaceted impact of vitamin D in this complex autoimmune disorder. While acknowledging some study heterogeneity, these results provide valuable insights into the potential therapeutic role of vitamin D in GO.


Conclusion: In conclusion, this systematic review underscores the potential significance of oral vitamin D supplementation in the management of Graves' Ophthalmopathy. Elevated serum vitamin D levels, observed improvements in disease activity, and effects on tear film parameters collectively suggest a promising avenue for future therapeutic interventions.

Abstract 90 | PDF Downloads 30

References

1. Khoo TK, Bahn RS. Pathogenesis of Graves' ophthalmopathy: the role of autoantibodies. Thyroid : official journal of the American Thyroid Association. 2007;17(10):1013-8.
2. Perros P, Hegedüs L, Bartalena L, Marcocci C, Kahaly GJ, Baldeschi L, et al. Graves' orbitopathy as a rare disease in Europe: a European Group on Graves' Orbitopathy (EUGOGO) position statement. Orphanet journal of rare diseases. 2017;12(1):72.
3. Şahlı E, Gündüz K. Thyroid-associated Ophthalmopathy. Turkish journal of ophthalmology. 2017;47(2):94-105.
4. Stan MN, Bahn RS. Risk factors for development or deterioration of Graves' ophthalmopathy. Thyroid : official journal of the American Thyroid Association. 2010;20(7):777-83.
5. Touil H, Mounts K, De Jager PL. Differential impact of environmental factors on systemic and localized autoimmunity. Frontiers in immunology. 2023;14:1147447.
6. Athanassiou L, Mavragani CP, Koutsilieris M. The Immunomodulatory Properties of Vitamin D. Mediterranean journal of rheumatology. 2022;33(1):7-13.
7. Sadaka A, Nguyen K, Malik A, Brito R, Berry S, Lee AG. Vitamin D and Selenium in a Thyroid Eye Disease Population in Texas. Neuro-ophthalmology (Aeolus Press). 2019;43(5):291-4.
8. Heisel CJ, Riddering AL, Andrews CA, Kahana A. Serum Vitamin D Deficiency Is an Independent Risk Factor for Thyroid Eye Disease. Ophthalmic plastic and reconstructive surgery. 2020;36(1):17-20.
9. Berezowska M, Coe S, Dawes H. Effectiveness of Vitamin D Supplementation in the Management of Multiple Sclerosis: A Systematic Review. International journal of molecular sciences. 2019;20(6).
10. Aranow C. Vitamin D and the immune system. Journal of investigative medicine : the official publication of the American Federation for Clinical Research. 2011;59(6):881-6.
11. Rana HS, Akella SS, Clabeaux CE, Skurski ZP, Aakalu VK. Ocular surface disease in thyroid eye disease: A narrative review. The ocular surface. 2022;24:67-73.
12. Zhang X, M VJ, Qu Y, He X, Ou S, Bu J, et al. Dry Eye Management: Targeting the Ocular Surface Microenvironment. International journal of molecular sciences. 2017;18(7).
13. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ (Clinical research ed). 2021;372:n71.
14. 2020 [Internet]. JBI Manual for Evidence Synthesis. Chapter 7: Systematic reviews of etiology and risk.
15. Lai YT, Cerquinho RG, Perez MM, Alves B, Pereira EC, Azzalis LA, et al. Determination of vitamin D in tears of healthy individuals by the electrochemiluminescence method. Journal of clinical laboratory analysis. 2019;33(4):e22830.
16. Raymond-Lezman JR, Riskin SI. Benefits and Risks of Sun Exposure to Maintain Adequate Vitamin D Levels. Cureus. 2023;15(5):e38578.
17. Ghaseminejad-Raeini A, Ghaderi A, Sharafi A, Nematollahi-Sani B, Moossavi M, Derakhshani A, et al. Immunomodulatory actions of vitamin D in various immune-related disorders: a comprehensive review. 2023;14.
18. Yang CY, Leung PS, Adamopoulos IE, Gershwin ME. The implication of vitamin D and autoimmunity: a comprehensive review. Clinical reviews in allergy & immunology. 2013;45(2):217-26.
19. Rashad R, Pinto R, Li E, Sohrab M, Distefano AG. Thyroid Eye Disease. Life (Basel, Switzerland). 2022;12(12).
20. Rosenblum MD, Gratz IK, Paw JS, Abbas AK. Treating human autoimmunity: current practice and future prospects. Science translational medicine. 2012;4(125):125sr1.
21. Zhang R, Naughton DP. Vitamin D in health and disease: current perspectives. Nutrition journal. 2010;9:65.
22. Dankers W, Colin EM, van Hamburg JP, Lubberts E. Vitamin D in Autoimmunity: Molecular Mechanisms and Therapeutic Potential. Frontiers in immunology. 2016;7:697.
23. Hosseini B, Tremblay CL, Longo C, Glochi S, White JH, Quach C, et al. Oral vitamin D supplemental therapy to attain a desired serum 25-hydroxyvitamin D concentration in essential healthcare teams. Trials. 2022;23(1):1019.
24. Zhao R, Zhang W, Ma C, Zhao Y, Xiong R, Wang H, et al. Immunomodulatory Function of Vitamin D and Its Role in Autoimmune Thyroid Disease. Frontiers in immunology. 2021;12:574967.
25. Kamen DL, Tangpricha V. Vitamin D and molecular actions on the immune system: modulation of innate and autoimmunity. Journal of molecular medicine (Berlin, Germany). 2010;88(5):441-50.
26. Planck T, Shahida B, Malm J, Manjer J. Vitamin D in Graves Disease: Levels, Correlation with Laboratory and Clinical Parameters, and Genetics. European thyroid journal. 2018;7(1):27-33.
27. Cho YY, Chung YJ. Vitamin D supplementation does not prevent the recurrence of Graves’ disease. Scientific Reports. 2020;10(1):16.
28. Kizilgul M, Kan S, Ozcelik O, Beysel S, Apaydin M, Ucan B, et al. Vitamin D Replacement Improves Tear Osmolarity in Patients with Vitamin D Deficiency. Seminars in ophthalmology. 2018;33(5):589-94.
29. Hwang JS, Lee YP, Shin YJ. Vitamin D Enhances the Efficacy of Topical Artificial Tears in Patients With Dry Eye Disease. Cornea. 2019;38(3):304-10.
30. Watts P, Sahai A, Kumar PR, Shamshad MA, Trivedi GK, Tyagi L. A prospective study to assess the role of vitamin D individually and in combination with cyclosporine in the treatment of dry eye in patients with deficient serum 25(OH)D levels. Indian journal of ophthalmology. 2020;68(6):1020-6.
31. Oncul H, Fuat Alakus M, Caglayan M, Yilmaz Oncul F, Dag U, Arac E. Impact of vitamin D supplementation on the ocular surface in patients with vitamin d deficiency. Annals of Medical Research. 2021;27(10):2726-30.
32. Lin Y, Su H, Wu J, Yuan M, Zhang Y. Oral vitamin D(3) supplementation for femtosecond LASIK-associated dry eye vitamin D for LASIK dry eye syndrome. International ophthalmology. 2022;42(10):3145-52.
33. Najjaran M, Zarei-Ghanavati S, Arjmand Askari E, Eslampoor A, Ziaei M. Effect of oral vitamin D supplementation on dry eye disease patients with vitamin D deficiency. Clinical & experimental optometry. 2023;106(3):257-62.
34. Yildirim P, Garip Y, Karci AA, Guler T. Dry eye in vitamin D deficiency: more than an incidental association. International journal of rheumatic diseases. 2016;19(1):49-54.
35. Bae SH, Shin YJ, Kim HK, Hyon JY, Wee WR, Park SG. Vitamin D Supplementation for Patients with Dry Eye Syndrome Refractory to Conventional Treatment. Sci Rep. 2016;6:33083.
36. Meng YF, Lu J, Xing Q, Tao JJ, Xiao P. Lower Serum Vitamin D Level Was Associated with Risk of Dry Eye Syndrome. Medical science monitor : international medical journal of experimental and clinical research. 2017;23:2211-6.
37. Kim MJ, Hwang HR, Kim YJ, Lee SY, Lee JG, Jeong DW, et al. Association Between Serum 25-Hydroxyvitamin D Levels and Dry Eye in Korean Adults: A Study Based on Korean National Health and Nutrition Examination Survey, 2010-2011. Korean journal of family medicine. 2017;38(2):81-5.
38. Jeon DH, Yeom H, Yang J, Song JS, Lee HK, Kim HC. Are Serum Vitamin D Levels Associated With Dry Eye Disease? Results From the Study Group for Environmental Eye Disease. Journal of preventive medicine and public health = Yebang Uihakhoe chi. 2017;50(6):369-76.
39. Pratita W, Arto KS, Arto NS. Efficacy of Vitamin-D Supplement on Thyroid Profile in Children with Graves’ Disease. Open Access Macedonian Journal of Medical Sciences. 2020;8(B):798-801.