(P23-054-23) Serum Vitamins and Retinal Nerve Fiber Layer Changes on SD-OCT: The Alienor Study

Objectives: Glaucoma, a multifactorial neurodegenerative disease, characterized by a progressive loss of retinal ganglion cells and a progressive thinning of the retinal nerve fiber layer (RNFL) on optical coherence tomography (OCT). Vitamins B6, B9 and B12 may contribute to retinal vascular diseases and optic neuropathies through their contribution to the homeostasis of homocysteine levels. Vitamins A, D and E may also be important for the protection of optic nerve due to their strong antioxidant properties.Thus, the aim was to investigate the relationship between serum vitamins A, D, E, B6, B9, B12 and longitudinal changes in RNFL thickness in the Alienor study.

Methods: The Alienor study is an ongoing population-based cohort of 963 older residents of Bordeaux (France) followed since 2006. RNFL thickness was measured with spectral domain-optical OCT (SD-OCT) every 2 years over an 8-year period. Serum vitamins A, D, E, B6, B9 and B12 were measured at baseline from fasting blood sample. Linear mixed models were used to assess the association between serum vitamin levels and RNFL changes over time, adjusted for age, gender, axial length, family history of glaucoma, alcohol consumption and vitamin D supplement use.

Results: This study included 1187 eyes (624 participants). Among all nutrients assessed, vitamins E and B9 were significantly associated with longitudinal changes in RNFL thickness. A 1-standard deviation (SD) increase of vitamin E (11 nmol/L) and of vitamin B9 (11 nmol/L) were associated with slower RNFL thinning by 0.15 µm/year (95% confidence interval (CI), 0.02-0.28, p=0.03), 0.12 µm/year (95% CI, 0.01-0.23, p=0.03), respectively. No significant association was observed for vitamins A, D, B6 and B12 with RNFL either at baseline or with longitudinal changes.

Conclusions: Higher levels of vitamins E and B9 were associated with a slower RNFL thickness on SD-OCT over time, suggesting that those vitamins may contribute to the neuroprotection of the optic nerve head and may be interesting in glaucoma management.

Funding Sources: The Alienor study is funded by Laboratoires Théa, Fondation Voir et Entendre, Agence Nationale de la Recherche (ANR 2010-PRSP-011 VISA), French Ministry of Health (PHRC 12_157, ECLAIR), CFSR Recherche (Club Français des Specialistes de la Retine), Fondation Visio and CNSA (Caisse Nationale pour la Solidarité et l’Autonomie).