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17 ["Vitamin D and its pathway genes in myopia: systematic review and meta-analysis"] 10.1136/bjophthalmol-2018-312159 2018-07-17T16:26:52Z ["Ophthalmology", "Sensory Systems", "Cellular and Molecular Neuroscience"] 56 8 ["0007-1161", "1468-2079"] British Journal of Ophthalmology <jats:sec><jats:title>Objective</jats:title><jats:p>To conduct a systematic review and meta-analysis of the association of blood vitamin D (25-hydroxyvitamin D, 25(OH)D) concentration and vitamin D pathway genes with myopia.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We searched the MEDLINE and EMBASE databases for studies published up to 29 January 2018. Cross-sectional or cohort studies which evaluated the blood 25(OH)D concentration, blood 25(OH)D3 concentration or vitamin D pathway genes, in relation to risk of myopia or refractive errors were included. Standard mean difference (SMD) of blood 25(OH)D concentrations between the myopia and non-myopia groups was calculated. The associations of blood 25(OH)D concentrations and polymorphisms in vitamin D pathway genes with myopia using summary ORs were evaluated.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>We summarised seven studies involving 25 008 individuals in the meta-analysis. The myopia group had lower 25(OH)D concentration than the non-myopia group (SMD=−0.27 nmol/L, p=0.001). In the full analysis, the risk of myopia was inversely associated with blood 25(OH)D concentration after adjusting for sunlight exposure or time spent outdoors (adjusted odds ratio (AOR)=0.92 per 10 nmol/L, p&lt;0.0001). However, the association was not statistically significant for the &lt;18 years subgroup (AOR=0.91 per 10 nmol/L, p=0.13) and was significant only for 25(OH)D3 (likely to be mainly sunlight derived), but not total 25(OH)D (AOR=0.93 per 10 nmol/L, p=0.00007; AOR=0.91 per 10 nmol/L, p=0.15). We analysed four single nucleotide polymorphisms in the VDR gene from two studies; there was no significant association with myopia.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Lower 25(OH)D is associated with increased risk of myopia; the lack of a genetic association suggests that 25(OH)D level may be acting as a proxy for time outdoors.</jats:p></jats:sec> 9 ["", "", "", "", ""] ["Shu Min Tang", "Tiffany Lau", "Shi Song Rong", "Seyhan Yazar", "Li Jia Chen", "David A Mackey", "Robyn M Lucas", "Chi Pui Pang", "Jason C Yam"] ["14111515 (JCSY)"] ["General Research Fund (GRF), Research Grants Council, Hong Kong", "UBS Optimus Foundation Grant", "Direct Grants of the Chinese University of Hong Kong"] [[""], [""], [""]]