Age-Related Vitamin D Deficiency Is Associated with Reduced Macular Ganglion Cell Complex: A Cross-Sectional High-Definition Optical Coherence Tomography Study

BACKGROUND Vitamin D deficiency is associated with smaller volume of optic chiasm in older adults, indicating a possible loss of the visual axons and their cellular bodies. Our objective was to determine whether vitamin D deficiency in older adults is associated with reduced thickness of the ganglion cell complex (GCC) and of the retinal nerve fibre layer (RNFL), as measured with high-definition optical coherence tomography (HD-OCT). METHODS Eighty-five French older community-dwellers without open-angle glaucoma and patent age-related macular degeneration (mean, 71.1±4.7 years; 45.9% female) from the GAIT study were separated into 2 groups according to serum 25OHD level (i.e., deficient≤25 nmol/L or sufficient>25 nmol/L). Measurements of GCC and RNFL thickness were performed using HD-OCT. Age, gender, body mass index, number of comorbidities, dementia, functional autonomy, intracranial volume, visual acuity, serum calcium concentration and season of testing were considered as potential confounders. RESULTS Mean serum 25OHD concentration was 58.4±26.8 nmol/L. Mean logMAR visual acuity was 0.03±0.06. Mean visual field mean deviation was -1.25±2.29 dB. Patients with vitamin D deficiency (n=11) had a reduced mean GCC thickness compared to those without vitamin D deficiency (72.1±7.4 μm versus 77.5±7.5 μm, P=0.028). There was no difference of the mean RNFL thickness in these two groups (P=0.133). After adjustment for potential confounders, vitamin D deficiency was associated with reduced GCC thickness (ß=-5.12, P=0.048) but not RNFL thickness (ß=-9.98, P=0.061). Specifically, vitamin D deficiency correlated with the superior medial GCC area (P=0.017) and superior temporal GCC area (P=0.010). CONCLUSIONS Vitamin D deficiency in older patients is associated with reduced mean GCC thickness, which can represent an early stage of optic nerve damage, prior to RNFL loss.