Authors: Xuewu Gong, Hongbo Yao, Jing Wu...

BACKGROUND

To determine the effect of sodium hyaluronate combined with recombinant human epidermal growth factor (rhEGF) on clinical symptoms and inflammation in patients with newly diagnosed xerophthalmia after cataract surgery.

METHODS

A total of 106 patients who underwent cataract surgery and were newly diagnosed with xerophthalmia in our hospital between June 2018 and August 2019 were enrolled. Of these, 50 patients who were treated with sodium hyaluronate (0.1%) were assigned to the monotherapy group (MG) and the remaining 56 patients who were treated with sodium hyaluronate (0.1%) combined with rhEGF (20 μg/ml) were assigned to the combination group (CG). The 2 groups were compared based on ocular surface disease index (OSDI) score, break-up time (BUT), fluorescein corneal staining level, Schirmer I test (SI) level, clinical efficacy (disappearance of typical symptoms, including eyes drying, burning sensation, foreign body sensation, etc), and interleukin (IL)-1, IL-6, and tumor necrosis factor-α (TNF-α) levels. Spearman correlation analysis was conducted to analyze the relationship between IL-1, IL-6, TNF-α and clinical efficacy. In addition, receiver operating characteristic curves were drawn to analyze the predictive value of IL-1, IL-6, and TNF-α in efficacy on xerophthalmia.

RESULTS

After treatment, the CG showed reduced OSDI score compared with the MG. The CG showed increased BUT (s) and SI (mm) levels compared with MG. After treatment, the CG exhibited decreased levels of IL-1(ng/mL), IL-6 (ng/mL), and TNF-α (ng/mL) compared with the MG. Spearman correlation analysis revealed that IL-1, IL-6, and TNF-α were negatively correlated with clinical efficacy. The areas under the curves of IL-1, IL-6, and TNF-α were 0.801, 0.800, and 0.736 respectively.

CONCLUSIONS

Sodium hyaluronate combined with rhEGF is helpful to alleviate clinical symptoms and inflammation in patients with xerophthalmia undergoing cataract surgery.

Topics: Cataract; Cataract Extraction; Epidermal Growth Factor; Humans; Hyaluronic Acid; Inflammation; Ophthalmic Solutions; Recombinant Proteins; Xerophthalmia

PubMed: 35130850
DOI: 10.1186/s12886-022-02275-4

Authors: Arman Enekvint, Wolf Wonneberger, Madeleine Zetterberg...

Vitamin A deficiency and xerophthalmia is a rare finding in developed countries. We report a severe case of xerophthalmia in a 7-year-old autistic child with restricted diet. Both eyes had Bitot's spots and ulceration. The right cornea had a perforation at admission. After treatment with high doses of vitamin A the right cornea epithelialized with formation of the anterior chamber and the left eye healed completely. This case adds to the increasing number of reports on cases of xerophthalmia particularly in autistic children and highlights the importance of considering vitamin A deficiency in patients with risk of malnutrition also in developed countries.

Topics: Autistic Disorder; Child; Humans; Infant; Malnutrition; Vitamin A; Vitamin A Deficiency; Xerophthalmia

PubMed: 34783001
DOI: No ID Found

Comparative Study

Authors: Abdelmoneim E M Kheir, Tarig O M O Dirar, Haifa O M Elhassan...

PURPOSE

To determine the prevalence of xerophthalmia at a traditional boarding school where children do not receive a diet adequate in vitamin A.

MATERIALS AND METHODS

A cross-sectional survey of 406 males residing in a Quranic traditional school was conducted using the World Health Organization xerophthalmia checklist. The association between the prevalence of night blindness and proportion of students staying at the school for 6 consecutive months and those eating solely at the school was investigated. The difference in age between children with night blindness and those without was investigated. Statistical significance was indicated by P<0.05.

RESULTS

The prevalence of night blindness, conjunctival xerosis and Bitot's spots was 24%, 12.5% and 1%, respectively. None of the boys had corneal ulceration, corneal scars and corneal xerosis. No significant association was observed between the differences in mean age and development of night blindness (P=0.657). There was a significant association between the duration of stay (cut-off of 6 months continuously) at the institute and the development of night blindness (P=0.023). There was no statistical significance between regularly eating at the maseed and outside the "maseed" and the development of night blindness (P=0.75).

CONCLUSION

Children residing at a traditional school are vulnerable to developing xerophthalmia where the diet is inadequate in vitamin A. Institutional caregivers should be made aware of the importance of providing a balanced diet rich in vitamin A. Institutional caregivers should also be educated on the signs and symptoms of vitamin A deficiency for early detection of xerophthalmia.

Topics: Adolescent; Cross-Sectional Studies; Follow-Up Studies; Humans; Male; Night Blindness; Prevalence; Retrospective Studies; Schools; Socioeconomic Factors; Sudan; Vitamin A Deficiency; Xerophthalmia

PubMed: 22623857
DOI: 10.4103/0974-9233.95247

Authors: S McLaughlin, J Welch, E MacDonald...

PURPOSE

Xerophthalmia refers to the ocular manifestations associated with vitamin A deficiency, including xerosis, keratomalacia, nyctalopia and Bitot's spot. Hypovitaminosis A is well-recognised in developing countries, but is rare in the developed world. Most cases in the latter relate to fat malabsorption. Conditions in which vitamin A metabolism or storage is deranged (chronic liver disease, including alcoholism) are also aetiologies. We wanted to see whether this was common in our department.

METHODS

Oral vitamin A supplements were given to patients who presented with hypovitaminosis A.

RESULTS

All patients were found to have hypovitaminosis A on biochemical testing and responded dramatically to oral vitamin A supplementation, resulting in an improved final visual outcome.

DISCUSSION

This series demonstrates that prompt recognition and treatment of xerophthalmia can lead to rapid recovery and avert significant visual morbidity. The prevalence of xerophthalmia is likely to increase in the developed world largely owing to alcoholic liver disease. It is thought by some that we are on the verge of a potential epidemic. We hope that by increasing the profile of this important public health issue, we may be able to influence future prevalence of hypovitaminosis.

Topics: Adult; Female; Humans; Male; Middle Aged; Treatment Outcome; Vitamin A; Vitamin A Deficiency; Vitamins; Xerophthalmia

PubMed: 24525868
DOI: 10.1038/eye.2014.17

Authors: Mimi Chiu, Stephanie Watson

We report the ocular and systemic manifestations of vitamin A deficiency in a child with a complicated medical history including autism and a restricted diet, living in a developed country. This child had significant vitamin A deficiency despite being under long-term medical care, yet the diagnosis was not considered until he had an ophthalmology review for visual deterioration.

Topics: Autistic Disorder; Child; Child Nutritional Physiological Phenomena; Diet; Feeding Behavior; Feeding and Eating Disorders of Childhood; Humans; Keratolytic Agents; Male; Malnutrition; Treatment Outcome; Tretinoin; Vision Disorders; Vitamin A; Vitamin A Deficiency; Xerophthalmia

PubMed: 26438671
DOI: 10.1136/bcr-2015-209413

Authors: Gizachew Tilahun Belete, Assefa Lake Fenta, Mohammed Seid Hussen...

INTRODUCTION

Xerophthalmia is a general term applied to all the ocular manifestations from night blindness through complete corneal destruction (keratomalacia) due to vitamin A deficiency. Xerophthalmia is the main contributing factors for childhood blindness in developing countries. However, there is limited evidence that can implicate the current situation. This study aimed to determine the magnitude of xerophthalmia and associated factors among school-age children in Northwest Ethiopia.

METHODS

A community-based cross-sectional study was conducted on 490 children, age range of 6 to 12 years. The study participants were selected through systematic random sampling method. Data were collected using a pretested structured questionnaire and ophthalmic examination with different ophthalmic instruments. The analyzed result was summarized and presented using descriptive statistics. Binary logistic regression was used to determine the factors associated with xerophthalmia. Variables with a value of <0.05 in the multivariable logistic regression analysis were considered as statistically significant.

RESULTS

A total of 484 study participants with a response rate of 98.8 were involved in this study, and their median age was 8 years with IQR of 4 years. The prevalence of xerophthalmia was 8.26% (95% CI: 5.8, 10.7). Family income less than 1000 Ethiopian birr (AOR = 4.65, 95% CI: 1.31, 16.4), presence of febrile illness (AOR = 2.8, 95% CI: 1.49, 6.11), poor consumption of fruits and vegetables (AOR = 3.18, 95% CI: 1.30, 7.80), and nonimmunized status (AOR = 3.43, 95% CI: 1.49, 7.89) were significantly associated with xerophthalmia.

CONCLUSIONS AND RECOMMENDATIONS

The prevalence of xerophthalmia was high as compared to the World Health Organization criteria for public health significance. Factors identified for xerophthalmia in this study are low income, the poor dietary practice of fruits and vegetables, and the presence of febrile illness and not immunized. Hence, it is a public problem that needs attention.

PubMed: 31885886
DOI: 10.1155/2019/5130904

Authors: Aiman Ifwat, On Heong Liew, Hanisah Abdul Hamid...

Xeropthalmia refers to a range of ocular symptoms caused by vitamin A deficiency (VAD), ranging from night blindness and Bitot's spots to corneal xerosis, ulceration, and keratomalacia, which can lead to blindness. We report two cases of xerophthalmia in children with intellectual disabilities. Ocular examination revealed generalized conjunctival xerosis, corneal xerosis, and dense superficial punctate keratopathy. Both share a history of a strict self-selective diet of mainly rice and noodles. Serum vitamin A levels for these children showed a very low level (<0.10 µmol/L) and were categorized as severe VAD. One of the cases showed signs of improvement, and the other one succumbed to death secondary to pneumonia. Therefore, proper history-taking, early detection, and prompt treatment are important to prevent the devastating sequelae of VAD.

PubMed: 35399490
DOI: 10.7759/cureus.22846

Authors: Sandeep Sachdeva

Topics: Female; Humans; Male; Vitamin A Deficiency; Xerophthalmia

PubMed: 22796705
DOI: No ID Found

Authors: Rupal Morjaria, Arijit Mitra, Peter McDonnell...

Topics: Female; Humans; Intestine, Small; Keratitis; Middle Aged; Postoperative Complications; Vitamin A Deficiency; Xerophthalmia

PubMed: 21357982
DOI: 10.1258/jrsm.2010.100326