Vitamin D enhances topical treatment of dry eye disease

Korea: Vitamin D may enhance the efficacy of topical dry eye treatment and can possibly be used as potential adjuvant therapy for patients with dry eye disease, according to a recently published study.

The study, published in the journal Cornea found that vitamin D supplementation enhanced the efficacy of topical CLAT and HU. Topical carbomer-based lipid-containing artificial tears (CLAT) and hyaluronate (HU) are used for the treatment of dry eye disease (DED).

Dry eye disease is characterized by inflammation of the cornea, the transparent outer layer of the eye and dysregulation of tears production. In severe dry eye disease, which often accompanies diseases such as Sjogren’s syndrome and ocular graft-versus-host disease, the inflammation in the corneal tissue can become extreme enough to cause disabling eye pain and sensitivity to light.

Jin Sun Hwang, Department of Ophthalmology, Hallym University College of Medicine, Seoul, Korea, and colleagues examined the efficacy of topical CLAT and hyaluronate HU in patients with dry eye disease based on serum 25-hydroxyvitamin D (25HD) levels and cholecalciferol (vitamin D) supplementation.

The researchers included a total of 116 patients with dry eye disease. They were divided into two groups vitamin D deficiency (VDD) group and the non-VDD group according to their serum 25HD levels. All patients, regardless of their vitamin D levels, were offered the choice of no supplementation, oral supplementation, or intramuscular supplementation.

Ocular Surface Disease Index (OSDI) score, visual analog pain scale score (VAPS), lid hyperemia, tear breakup time (TBUT), corneal fluorescein staining score, and Schirmer test were evaluated at baseline and 2 weeks following treatment.

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Key findings of the study include:

• The OSDI and visual analog pain scale scores of both VDD and non-VDD groups decreased after application of topical CLAT and HU compared with baseline values.


• TBUT, corneal fluorescein staining score, and lid hyperemia in the VDD group remained unaffected by topical CLAT and HU, whereas those in the non-VDD group were improved (3.2 ± 1.7 vs. 4.1 ± 2.2, 0.5 ± 0.7 vs. 0.4 ± 0.6, and 2.2 ± 0.8 vs. 1.9 ± 0.7 in the non-VDD group).


• OSDI score, TBUT, and lid margin hyperemia were improved in the intramuscular group after cholecalciferol supplementation compared with pretreatment (33.2 ± 23.2 vs. 28.5 ± 21.9, 3.5 ± 1.9 vs. 6.0 ± 2.5, and 2.2 ± 0.7 vs. 1.2 ± 0.8).

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"Our findings suggest that vitamin D supplements increase the efficacy of lubricant eye preparations and help patients suffering from dry eye disease. Vitamin D supplementation by the intramuscular route may enhance the efficacy of topical dry eye treatments, and can possibly be used as potential adjuvant therapy for patients with dry eye disease," concluded the authors.

To read the complete study log on to doi: 10.1097/ICO.0000000000001822