A prospective cohort study of vitamin D in optic neuritis recovery

作者：Burton Jodie M^*; Eliasziw Misha; Trufyn Jessie; Tung Chelsia; Carter Gorden; Costello Fiona

来源：Multiple Sclerosis, 2017, 23(1): 82-93.

DOI：10.1177/1352458516642315

• Multiple sclerosis
• optic neuritis
• vitamin D
• optical coherence tomography
• gender
• neuroprotection

Background: Vitamin D sufficiency is associated with better inflammatory outcomes in multiple sclerosis (MS). We hypothesize that it is also associated with better long-term neurodegenerative measures.
Objectives: To show that vitamin D sufficient patients (25-hydroxy vitamin D (25(OH) D) >80 nmol/L) have better optical coherence tomography (OCT) neuroaxonal measures of ganglion cell layer (GCL) and retinal nerve fiber layer (RNFL) thickness after optic neuritis.
Methods: In this prospective cohort study, acute optic neuritis patients underwent OCT and serum 25(OH) D assessments at baseline and at month 6, with comparisons between vitamin D sufficient and insufficient patients, and men and women. Potential confounding variables were evaluated.
Results: Of 49 enrolled, 36 had complete, analyzable data. At baseline, vitamin D insufficiency was associated with greater RNFL thickness (134.3 vs. 95.2 mu m; p = 0.003) in affected eyes. At month 6, insufficient patients had greater GCL thinning (GCL inter-eye difference: 14.2 vs. 4.0 mu m, p = 0.008). Men had greater RNFL and GCL thinning than women (GCL: 61.2 vs. 69.6 mu m, p = 0.036).
Conclusion: Acutely, in optic neuritis, RNFL thickness is increased with vitamin D insufficiency. Chronically, neuronal, and possibly axonal loss are associated with vitamin D insufficiency and male gender, suggesting vitamin D and female gender may confer neuroprotection in optic neuritis, and possibly, central nervous system (CNS) inflammatory disease.

• 出版日期2017-1