Oral Vitamin D Supplementation and Clinical Outcomes of Intravitreal Bevacizumab Injection for Macular Edema Secondary to Retinal Vein Occlusions

To evaluate the therapeutic response of retinal vein occlusion (RVO) to intravitreal bevacizumab (IVB) with and without concomitant vitamin D supplementation.

Seventy eyes of 68 patients with macular edema associated with branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO) received three monthly IVB injections. Patients with serum 25-hydroxyvitamin D (25(OH) D) higher than 30 ng/ml were considered as the sufficient group. Cases with serum 25(OH) D levels below 30 ng/ml were randomized into the treatment and control groups. The control group received 50,000 IU of oral vitamin D, weekly for two months. One month after the last IVB injection, best-corrected visual acuity (BCVA) and central macular thickness (CMT) were measured and compared with the preinjection values.

While 43 eyes (61.4%) of 42 patients had BRVO, 27 eyes (38.6%) of 26 patients had CRVO. In BRVO patients, changes of CMT and BCVA were not significantly different between the sufficient, control, and treatment groups (P = 0.58 and 0.64, respectively). In the CRVO group, CMT reduction in the control group was significantly less than the sufficient and treatment groups (P = 0.048). In addition, improvement of BCVA in the control group was significantly less (P = 0.036) than the sufficient and treatment groups.

Oral vitamin D supplement therapy may improve anatomical and functional outcomes in patients with CRVO and vitamin D deficiency.