ArticleAmerican journal of ophthalmology2026
Vitamin D Deficiency and Dry Eye Disease: A Retrospective Cohort Study.
Article in American journal of ophthalmology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeDry eye disease (DED) is a common ocular surface disorder associated with ocular discomfort, visual disturbance, and reduced quality of life. Vitamin D has anti-inflammatory and immunomodulatory properties, and deficiency may predispose individuals to ocular surface disease. This study evaluated the association between vitamin D deficiency and incident DED.
designRetrospective cohort study. SUBJECTS: Adults aged ≥18 years identified from the TriNetX U.S. Collaborative Network. After 1:1 propensity score matching, 6,047,502 patients with vitamin D deficiency were compared with 6,047,502 matched controls without vitamin D deficiency.
methodsDe-identified electronic health records with up to 20 years of follow-up were analyzed. Vitamin D deficiency was defined using ICD-10 code E55. Controls were patients undergoing routine medical examinations without abnormal findings (ICD-10: Z00.00). Propensity score matching was performed for age, sex, and relevant comorbidities. Time-to-event analyses were conducted using Cox proportional hazards models. Kaplan-Meier curves and log-rank tests compared cumulative incidence between cohorts. Risk ratios (RRs) and odds ratios (ORs) were calculated from end-of-follow-up incidence proportions.
main outcome measuresIncident dry eye disease, defined by ICD-10 code H04.12.
resultsDED developed in 196,639 patients (3.3%) with vitamin D deficiency and 160,141 patients (2.7%) without deficiency. Vitamin D deficiency was associated with a significantly increased risk of DED (hazard ratio [HR], 1.286; 95% CI, 1.277-1.294; p < .001). Kaplan-Meier curves demonstrated a higher cumulative incidence in the vitamin D-deficient cohort (log-rank χ² = 5590.618; p < .001). The risk ratio was 1.242 (95% CI, 1.234-1.250; p < .001), and the odds ratio was 1.250 (95% CI, 1.242-1.259; p < .001). Limitations include reliance on diagnostic coding and lack of serum vitamin D level data.
conclusionsVitamin D deficiency was significantly associated with an increased risk of developing DED, with a 28.6% higher hazard compared with matched controls. These findings suggest that vitamin D deficiency may represent a modifiable risk factor for DED and support further prospective studies to evaluate the role of vitamin D supplementation in prevention and management.
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