TY - JOUR
T1 - Response of Bitot's spots to a single oral 100,000- or 200,000-IU dose of vitamin A
AU - Sovani, I.
AU - Humphrey, J. H.
AU - Kuntinalibronto, D. R.
AU - Natadisastra, G.
AU - Tielsch, James M
N1 - Funding Information:
From Cicendo Eye Hospital, Bandung, Indonesia (Drs. Sovani, Kuntinalibronto, and Natadisastra); Dana Center for Preventive Ophthalmology, Wilmer Institute and School of Public Health, Johns Hopkins University, Baltimore, Maryland (Drs. Humphrey and Tielsch); and Nutrition Research and Development Centre, Ministry of Health, Bogor, Indonesia (Dr. Muhilal). This study was supported by The Thrasher Research Fund, Salt Lake City, Utah (Dr. Humphrey), cooperative agreement DAN-0045-A-5094 between the Dana Center for Preventive Ophthalmology, Johns Hopkins University, and the Bureau of Research and Development, Office of Nutrition, United States Agency for International Development, Washington, D.C.; and grant RR-04060 from the National Institutes of Health, Bethesda, Maryland, with assistance from Task Force Sight and Life, Hoffmann LaRoche, Basel, Switzerland.
PY - 1994
Y1 - 1994
N2 - PURPOSE: A randomized, controlled clinical trial was conducted in Indonesia to study the response of Bitot's spots to a 100,000-IU dose of vitamin A, which is known to be associated with fewer acute side effects than the currently recommended 200,000-IU dose. METHODS: A total of 114 children (ages 13 to 59 months) with Bitot's spots were given an ocular examination; serum retinol concentration was measured, and the relative dose response test carried out. After administering one 100,000- or 200,000-IU oral dose of vitamin A, ocular examinations were repeated weekly for seven weeks and then biweekly for 20 more weeks, or until lesions were healed on two consecutive examinations. RESULTS: Either dose of vitamin A was similarly effective in healing Bitot's spots. The most important factor in predicting responsiveness to treatment was baseline serum retinol concentration: children with lower pretreatment concentrations were more likely to have responsive lesions. No child had a relapse within the first three months after treatment. However, by six months, children who had received the higher dose were 82% less likely to have a relapse compared with children who had received the lower dose. CONCLUSIONS: Although either a 100,000- or 200,000-IU dose of vitamin A is similarly effective in healing Bitot's spots, a 200,000-IU dose provides longer protection. This benefit justifies the higher rates of transient mild side effects associated with the 200,000-IU dose. The current 200,000-IU dose of vitamin A recommended by the World Health Organization for prophylactic dosing should not be reduced.
AB - PURPOSE: A randomized, controlled clinical trial was conducted in Indonesia to study the response of Bitot's spots to a 100,000-IU dose of vitamin A, which is known to be associated with fewer acute side effects than the currently recommended 200,000-IU dose. METHODS: A total of 114 children (ages 13 to 59 months) with Bitot's spots were given an ocular examination; serum retinol concentration was measured, and the relative dose response test carried out. After administering one 100,000- or 200,000-IU oral dose of vitamin A, ocular examinations were repeated weekly for seven weeks and then biweekly for 20 more weeks, or until lesions were healed on two consecutive examinations. RESULTS: Either dose of vitamin A was similarly effective in healing Bitot's spots. The most important factor in predicting responsiveness to treatment was baseline serum retinol concentration: children with lower pretreatment concentrations were more likely to have responsive lesions. No child had a relapse within the first three months after treatment. However, by six months, children who had received the higher dose were 82% less likely to have a relapse compared with children who had received the lower dose. CONCLUSIONS: Although either a 100,000- or 200,000-IU dose of vitamin A is similarly effective in healing Bitot's spots, a 200,000-IU dose provides longer protection. This benefit justifies the higher rates of transient mild side effects associated with the 200,000-IU dose. The current 200,000-IU dose of vitamin A recommended by the World Health Organization for prophylactic dosing should not be reduced.
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U2 - 10.1016/S0002-9394(14)72560-7
DO - 10.1016/S0002-9394(14)72560-7
M3 - Article
C2 - 7977607
AN - SCOPUS:0027973215
SN - 0002-9394
VL - 118
SP - 792
EP - 796
JO - American journal of ophthalmology
JF - American journal of ophthalmology
IS - 6
ER -