Analysis of pupillary responses in pediatric patients with vitamin D deficiency
Graefes Arch Clin Exp Ophthalmol . 2024 Feb 28. doi: 10.1007/s00417-024-06428-7
Gamze Yıldırım Biçer 1, Zeynep Yılmaz Öztorun 2, Kadir Eren Biçer 3, Kürşad Ramazan Zor 4
Purpose: To evaluate the effects of vitamin D deficiency on pupillary responses in the pediatric population.
Methods: The study was conducted using data from the right eyes of 52 children with vitamin D deficiency and 52 healthy children. Measurements were taken under static and dynamic conditions with automatic pupillometry. Static measurements were performed at scotopic, mesopic, and photopic light intensities. The mean pupil dilation speed was calculated by observing the changes in pupil dilation over time according to dynamic measurements. Differences between patient and control groups were analyzed for the static and dynamic measurements and the mean pupil dilation speed.
Results: While the two groups were similar in terms of scotopic, mesopic, the first dynamic measurements, and the pupil dilation speed data (p > 0.05), a significant difference was found in the photopic conditions (p = 0.001). The mean pupil diameter of the patient group was 4.46 ± 0.928 mm and 3.95 ± 0.556 mm in the control group under photopic conditions.
Conclusions: Pediatric patients with vitamin D deficiency have significantly larger pupil diameters in photopic conditions than healthy children. These results suggest that there is an autonomic dysfunction in vitamin D deficiency in the pediatric population, especially pointing to the parasympathetic system.
49 References
- Aksoy Aydemir G, Aydemir E, Asik A (2022) Changes in tear meniscus analysis of children who have type 1 diabetes mellitus, with and without vitamin D deficiency. Cornea 41(11):1412–1417
- Antonucci R, Locci C, Clemente MG, Chicconi E, Antonucci L (2018) vitamin D deficiency in childhood: old lessons and current challenges. J Pediatr Endocrinol Metab 31(3):247–260
- Gartner LM, Greer FR (2003) Prevention of rickets and vitamin D deficiency: new guidelines for vitamin D intake. Pediatrics 111:908–910
- Pfotenhauer KM, Shubrook JH (2017) vitamin D deficiency, its role in health and disease, and current supplementation recommendations. J Am Osteopath Assoc 117(5):301–305
- Veronikis AJ, Cevik MB, Allen RH et al (2020) Evaluation of a ultraviolet B light emitting diode (LED) for producing vitamin D(3) in human skin. Anticancer Res 40(2):719–722
- Baggerly CA, Cuomo RE, French CB et al (2015) Sunlight and vitamin D: necessary for public health. J Am Coll Nutr 34(4):359–365
- Holick MF (2004) Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr 80(6 Suppl):1678S-S1688
- Heaney RP (2003) Long-latency deficiency disease: insights from calcium and vitamin D. Am J Clin Nutr 78:912–919
- Holick MF (2005) vitamin D: important for prevention of osteoporosis, cardiovascular heart disease, type 1 diabetes, autoimmune diseases, and some cancers. South Med J 98:1024–1027
- Bivona G, Gambino CM, Iacolino G, Ciaccio M (2019) vitamin D and the nervous system. Neurol Res 41(9):827–835
- Wrzosek M, Łukaszkiewicz J, Wrzosek M et al (2013) vitamin D and the central nervous system. Pharmacol Rep 65(2):271–278
- Burt MG, Mangelsdorf BL, Stranks SN, Mangoni AA (2016) Relationship between vitamin D status and autonomic nervous system activity. Nutrients 8(9):565
- Dogdus M, Burhan S, Bozgun Z et al (2019) Cardiac autonomic dysfunctions are recovered with vitamin D replacement in apparently healthy individuals with vitamin D deficiency. Ann Noninvasive Electrocardiol 24(6):e12677
- Morelli P, Oddo M, Ben-Hamouda N (2019) Role of automated pupillometry in critically ill patients. Minerva Anestesiol 85(9):995–1002
- Chopra R, Mulholland PJ, Petzold A et al (2020) Automated pupillometry using a prototype binocular optical coherence tomography system. Am J Ophthalmol 214:21–31
- SerbestCeylanoglu K, Sen EM, Sekeroglu MA (2022) Static and dynamic pupillary features in graves’ ophthalmopathy. Clin Exp Optom 1:1–5
- Öztürk Y, Yıldız MB, Bolaç R (2021) Evaluation of Pupillometric parameters in patients with COVID-19. Ocul Immunol Inflamm 12:1–5
- Luz Teixeira T, Peluso L, Banco P et al (2021) Early pupillometry assessment in Traumatic brain injury patients: a retrospective study. Brain Sci 11(12):1657
- Kim HM, Yang HK, Hwang JM (2018) Quantitative analysis of pupillometry in isolated third nerve palsy. PLoS ONE 13(11):e0208259
- Dominguez LJ, Farruggia M, Veronese N, Barbagallo M (2021) vitamin D sources, metabolism, and deficiency: available compounds and guidelines for its treatment. Metabolites 11(4):255
- Neyzi O, Bundak R, Gökçay G et al (2015) Reference values for weight, height, head circumference, and body mass index in Turkish children. J Clin Res Pediatr Endocrinol 7:280–293
- Gil Á, Plaza-Diaz J, Mesa MD (2018) vitamin D: classic and novel actions. Ann Nutr Metab 72(2):87–95
- Pignolo A, Mastrilli S, Davì C et al (2022) vitamin D and Parkinson’s disease. Nutrients 14(6):1220
- Sultan S, Taimuri U, Basnan SA et al (2020) Low vitamin D and its association with cognitive impairment and dementia. J Aging Res 2020:6097820
- Cannell JJ (2017) vitamin D and autism, what’s new? Rev Endocr Metab Disord 18(2):183–193
- Wadhwania R (2017) Is vitamin D deficiency implicated in autonomic dysfunction? J Pediatr Neurosci 12(2):119–123
- Chaudhari SA, Sacerdote A, Bahtiyar G (2012) 1-α hydroxylation defect in postural orthostatic tachycardia syndrome: remission with calcitriol supplementation. BMJ Case Rep 2012:bcr0220125730
- Ometto F, Stubbs B, Annweiler C et al (2016) Hypovitaminosis D and orthostatic hypotension: a systematic review and meta-analysis. J Hypertens 34(6):1036–1043
- Mann MC, Exner DV, Hemmelgarn BR et al (2013) vitamin D levels are associated with cardiac autonomic activity in healthy humans. Nutrients 5(6):2114–2127
- Matter M, El-Sherbiny E, Elmougy A, Abass M, Aldossary S, Ali WA (2016) Myocardial function in Saudi adolescents with vitamin D deficiency: Tissue Doppler imaging study. J Saudi Heart Assoc 28(1):22–30
- Kwon KY, Jo KD, Lee MK et al (2016) Low serum vitamin D levels may contribute to gastric dysmotility in de novo Parkinson’s disease. Neurodegener Dis 16(3–4):199–205
- Alabi EB, Simpson TL (2020) Pupil response to noxious corneal stimulation. PLoS ONE 15(1):e0227771
- Oshorov AV, Alexandrova EV, Muradyan KR, Sosnovskaya OY, Sokolova EY, Savin IA (2021) pupillometry as a method for monitoring of pupillary light reflex in ICU patients. Zh Vopr Neirokhir Im N N Burdenko 85(3):117–123
- de Vries L, Fouquaet I, Boets B, Naulaers G, Steyaert J (2021) Autism spectrum disorder and pupillometry: a systematic review and meta-analysis. Neurosci Biobehav Rev 120:479–508
- Godau J, Bierwirth C, Rösche J, Bösel J (2021) Quantitative infrared pupillometry in nonconvulsive status ePILEPTICUS. Neurocrit Care 35(1):113–120
- Erdem S, Karahan M, Ava S, Pekkolay Z, Demirtas AA, Keklikci U (2020) The effectiveness of automatic pupillometry as a screening method to detect diabetic autonomic neuropathy. Int Ophthalmol 40(11):3127–3134
- Picetti E, Robba C (2022) pupillometry and sepsis-associated encephalopathy. Minerva Anestesiol 88(5):332–333
- Karahan M, Demirtaş AA, Hazar L et al (2021) Autonomic dysfunction detection by an automatic pupillometer as a non-invasive test in patients recovered from COVID-19. Graefes Arch Clin Exp Ophthalmol 259(9):2821–2826
- Jackson KG, Malphrus EL, Blum E, Kalloo NB, Finkel JC (2019) Pupillometric assessment of dysautonomia in pediatric bowel and bladder dysfunction: a pilot study. J Pediatr Urol 15(3):226.e1-226.e5
- Pena MM, Donaghue KC, Fung AT et al (1995) The prospective assessment of autonomic nerve function by pupillometry in adolescents with type 1 diabetes mellitus. Diabet Med 12(10):868–873
- Connelly MA, Brown JT, Kearns GL, Anderson RA, St Peter SD, Neville KA (2014) pupillometry: a non-invasive technique for pain assessment in paediatric patients. Arch Dis Child 99(12):1125–1131
- Palmer AC, Healy K, Barffour MA et al (2016) Provitamin A carotenoid-biofortified maize consumption increases pupillary responsiveness among Zambian children in a randomized controlled trial. J Nutr 146(12):2551–2558
- Healy K, Palmer AC, Barffour MA et al (2018) Nutritional status measures are correlated with pupillary responsiveness in Zambian children. J Nutr 148(7):1160–1166
- Zhang Q, Sun Y, Zhang C, Qi J, Du J (2021) vitamin D deficiency and vasovagal syncope in children and adolescents. Front Pediatr 9:575923
- McDougal DH, Gamlin PD (2015) Autonomic control of the eye. Compr Physiol 5(1):439–473
- Maser RE, Lenhard MJ, Pohlig RT (2015) vitamin D insufficiency is associated with reduced parasympathetic nerve fiber function in type 2 diabetes. Endocr Pract 21(2):174–181 PDF
- Yorulmaz IS, Demiraran Y, Özlü O, Dost B (2020) The effect of vitamin D status on different neuromuscular blocker agents reverse time. Turk J Med Sci 50(4):749–755
- Hribová P, Sotak Š (2022) vitamin D and ophthalmopathias. A review Cesk Slov Oftalmol 78(4):153–156
- Graffe A, Milea D, Annweiler C et al (2012) Association between hypovitaminosis D and late stages of age-related macular degeneration: a case-control study. J Am Geriatr Soc 60(7):1367–1369
- Chan HN, Zhang XJ, Ling XT et al (2022) vitamin D and ocular diseases: a systematic review. Int J Mol Sci 23(8):4226
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