Conduct serology testing in cases of NCP to manage potential underlying vitamin abnormalities.

Conduct serology testing in cases of NCP to manage potential underlying vitamin abnormalities. Photo: Helvetia Diagnostics. Click image to enlarge.

The role of abnormal vitamin D and B levels in various neurological conditions has previously been established. However, to date, the relationship between vitamin levels and neuropathic corneal pain (NCP), a condition characterized by abnormal nerve function, has not been studied. Research presented last Sunday at ARVO 2023 in New Orleans explored these vitamin abnormalities as a possible underlying etiology in NCP.

“Our findings indicate that vitamin abnormalities are common in patients with NCP, specifically low B2, high B6 and low vitamin D,” the investigators wrote in their abstract. “High vitamin B6 levels was one of the most common findings, supporting literature that B6 toxicity may lead to neuropathy. Vitamin D deficiencies are more common in patients 18 to 30 years and in males.”

The retrospective study included 84 patients with NCP. The majority of the participants (age: 40.8±12.9 years) were female (65.5%), white (77.4%) and of non-Hispanic or Latino origin (82.1%). Serology results and demographics were collected, and binary logistic regressions and contingency tables were used to assess the odds of an abnormal test result compared with normal levels based on demographics.

At least one vitamin abnormality was found in 52.4% of patients, most common being low B2 (31.0%), high B6 (28.9%), high B12 (15.0%) and low vitamin D (15.8%). Males had higher odds than females of having a vitamin D3 deficiency (OR: 4.5). The predictive value of having a vitamin D3 deficiency decreased as age increased (OR: 0.9). Specifically, patients aged 18 to 33 had higher odds of having vitamin D3 deficiency (OR: 4.89). No category of race was at greater risk for a vitamin abnormality, and no demographic group was at greater risk for a vitamin B abnormality.

“Serology testing may help treat underlying conditions early, especially in males under 33,” the team concluded. “Investigating changes in clinical findings/pain after treating abnormal levels would further illustrate the role vitamins play in NCP.”

Original abstract content © Association for Research in Vision and Ophthalmology 2023.

Bogen CS, Cox S, Hamrah P. Role of vitamin abnormalities as possible underlying etiology in patients with neuropathic corneal pain. ARVO 2023 annual meeting.