Vitamin D and tear fluid cytokines in predicting outcomes in viral conjunctivitis - A new outlook

Gairik Kundu; Rohit Shetty; Durgalaxmi Modak; Ameeta Koul; Srihari Balaraj; Harsha Nagaraja; Swaminathan Sethu

doi:10.4103/IJO.IJO_2345_23

Vitamin D and tear fluid cytokines in predicting outcomes in viral conjunctivitis - A new outlook

Indian J Ophthalmol. 2024 Apr 16. doi: 10.4103/IJO.IJO_2345_23. Online ahead of print.

Authors

Gairik Kundu¹, Rohit Shetty¹, Durgalaxmi Modak¹, Ameeta Koul¹, Srihari Balaraj¹, Harsha Nagaraja¹, Swaminathan Sethu²

Affiliations

¹ Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, Karnataka, India.
² GROW Research Laboratory, Narayana Nethralaya Foundation, Bangalore, Karnataka, India.

PMID: 38622859
DOI: 10.4103/IJO.IJO_2345_23

Abstract

Purpose: To determine the association between systemic vitamin D (VD) and immunoglobulin E (IgE) levels with severity and ocular surface inflammatory profile in patients with epidemic keratoconjunctivitis (EKC).

Methods: 210 eyes of 105 patients who were clinically diagnosed with EKC were included in the study. The levels of serum VD and serum IgE were measured. Schirmer's strip-based tear fluid (TF) was used to determine levels of IL-1β, IL-6, IL-10, IL-17A, TNFα, MMP9, sICAM1, and VEGF-A in a subset of patients.

Results: Levels of VD were significantly ( P < 0.05) lower and levels of IgE were significantly higher in patients with severe forms of conjunctivitis compared to those with nonsevere forms. Majority of the patients with severe forms of the disease exhibited VD deficiency and/or abnormally high IgE. A negative correlation (r = -0.682; P < 0.0001) was observed between VD and IgE levels. TF levels of IL-1β, IL-6, TNFα, and sICAM1 were significantly higher in eyes with severe forms of conjunctivitis compared to those with nonsevere forms and controls. These factors showed a positive correlation ( P < 0.05) with IgE levels and a negative correlation ( P < 0.05) with VD levels.

Conclusion: Patients with severe forms of EKC exhibited VD deficiency and higher levels of IgE. Increased TF inflammatory factors demonstrated a disease causal relationship with VD and IgE. Hence, restoring the altered levels of VD and IgE to normal range would be pivotal in the prevention and management of severe conjunctivitis.