Q&A: The potential impact of vitamin D on retinal surgery

Steven D. Ness, MD, at the ASRS 2025 meeting in Long Beach, California.

At the American Society of Retina Specialists (ASRS) annual meeting, Ophthalmology Times spoke to Steven D. Ness, MD. Ness is an attending physician at the VA Boston Healthcare System and an assistant professor at Boston University. At ASRS 2025, he gave a presentation titled, "Association of Serum Vitamin D Insufficiency With Proliferative Vitreoretinopathy After Rhegmatogenous Retinal Detachment Repair."

In our conversation, he highlighted key points from this presentation and the efforts for additional research to explore this potential association.

Note: The following conversation has been lightly edited for clarity.

Ophthalmology Times: You presented on the potential impact of vitamin D levels in association with complications in retinal surgery at the 2025 ASRS meeting. Can you share a few highlights from your presentation?

Steven D. Ness, MD: Yes, so we did a study at the VA looking at patients that had primary rhegmatogenous detachments and received surgical treatment. To be included in the study, they also had to have a serum vitamin D level drawn within 1 year of surgery. There's some data out there in terms of uveitis, that patients with low vitamin D levels are at higher risk for uveitis, and since PVR is also, at least in part, an inflammatory disease, we decided to look at whether vitamin D levels could contribute to PVR risk as well. We enrolled 313 patients; 42 of the patients developed PVR after surgery. For patients that had low vitamin D, they were they were over 4 times higher risk for development of PVR after detachment surgery. When we looked at vitamin D as a continuous variable, we found that for each 1 nanogram per milliliter, decrease in vitamin D levels that was associated with a 4% increased risk of PVR. So pretty statistically significant and potentially clinically relevant results from this study.

This is the first study that's shown any association, and you always have to take it with a grain of salt. This is a pretty specific patient population at the VA. That patient population, over 95% of the patients are males, over 80% are Caucasian. So it may not apply more broadly. Hopefully, with bigger and more diverse patient cohorts in future studies, we will see whether this bears out. That being said, you know, doing vitamin D therapy, it's an oral pill, or you can go and sit outside in the sunlight and get your Vitamin D that way. So it's a pretty low risk, low expense, treatment, which, if it can potentially decrease the risk of a really severe surgical complication, a complication that usually results in multiple surgeries and very poor vision outcomes, I don't think there's a lot to lose by trying.

OT: What does the future hold for this area of research?

Ness: So we're looking at some of the larger databases now to try and get more of a diverse patient population to see whether this bears out. The nice thing about this study was that we were able to do individual chart reviews, so we could look through every patient's chart. We could make sure that they had no PVR at the time of diagnosis, because we know pre-operative PVR is a risk factor for post-operative PVR. We tried to take really the bread and butter primary, easy retinal detachments that we all do all the time, to make this data as clean as possible.

You can't really do that in the database studies because they don't have that data there. It'll be looking at different patient populations. When we do these larger database studies.