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Effect of oral supplement D (D3 cholecalciferol) on serum vitamin D levels, tear film and disease severity of graves ophthalmopathy patients using a noninvasive ocular surface analyzer
Lestari A.A.
Gazzetta Medica Italiana Archivio Per Le Scienze Mediche
Q4Abstract
BACKGROUND: The cause of eye discomfort in Graves’ ophthalmopathy (GO) is the dry eye disease (DED) due to eyelid retraction, increased exposure of the ocular surface, and deficiency of aqueous tear film. Vitamin D deficiency is associated with DED symptoms in GO and is a therapeutic option. This study aimed to determine serum vitamin D levels, disease activity, and tear films using the noninvasive ocular surface analyzer in GO patients before and after vitamin D administration.METHODS: This study used non-randomized interventional study design. The sampling method used experimental and control groups. Measuring serum vitamin D levels with Elisa, GO disease activity was measured using the Clinical Activity Score (CAS) and tear film was measured using a noninvasive ocular surface analyzer.RESULTS: Serum vitamin D levels in GO patients before being given vitamin D 10,000 IU were 13.8% insufficiency and 73.3% sufficiency, after administration 13.3% excess and 86.7% potential excess (P=0.001) while in the control group it was 100% insufficiency became 14.3% sufficiency, 78.6% excess and 7.1% potential toxic (P=0.001). There was an improvement in CAS results before administering 10,000 IU of vitamin D from 15 samples (100%) active category to 15 (100%) inactive categories (P=0.001), while in the control group from 14 samples (100%) active category became 2 (14.3%) active category and 12 (85.7%) inactive categories (P=0.001). The results of tear film examination with a noninvasive ocular surface analyzer showed no significant improvement in GO patients (P>0.05) and no significant worsening in the control group (P>0.05) after administering 10,000 IU of vitamin D.CONCLUSIONS: Supplementation of 10,000 IU of vitamin D orally for 1 month increased serum vitamin D levels and improved CAS significantly but not tear film significantly.