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Vitamin A supplementation improves retinal function in infants at risk of retinopathy of prematurity
Helen Mactier1, Daphne L McCulloch, Ruth Hamilton
1Princess Royal Maternity, Glasgow, Scotland, UK. helen.mactier@ggc.scot.nhs.uk
Insights
Early high-dose vitamin A supplementation improved retinal sensitivity in preterm infants. This intervention may enhance visual function in vulnerable newborns, offering a potential benefit for long-term eye health.
Area of Science:
- Neonatal ophthalmology
- Nutritional science
- Developmental pediatrics
Background:
- Preterm infants often exhibit reduced retinal sensitivity at term corrected age.
- Vitamin A is crucial for visual function and retinal development.
- Early nutritional support is vital for preterm infants.
Purpose of the Study:
- To investigate the effect of early, high-dose vitamin A supplementation on retinal sensitivity in preterm infants.
- To test if vitamin A improves retinal function in infants at risk of retinopathy of prematurity.
Main Methods:
- A double-blind, randomized controlled trial involving infants <32 weeks gestation or <1501g birth weight.
- Supplemented group received intramuscular vitamin A (10,000 IU 3x weekly) from day 2.
- Retinal sensitivity measured by electroretinogram at 36 weeks postmenstrual age (PMA).
Main Results:
- Supplemented infants showed higher plasma retinol levels at 7 and 28 days.
- Retinal sensitivity was significantly greater in the vitamin A supplemented group at 36 weeks PMA.
- No significant difference in hepatic stores (RDR) or plasma retinol at 36 weeks PMA between groups.
Conclusions:
- Early high-dose intramuscular vitamin A supplementation enhances retinal function in preterm infants at 36 weeks PMA.
- This intervention shows promise for improving visual outcomes in infants at risk of retinopathy of prematurity.
Objective:
Preterm infants show reduced retinal sensitivity at term corrected age compared with newborn term infants. We tested the hypothesis that retinal sensitivity in preterm infants is improved by early, high-dose vitamin A.
Study Design:
We report a double-blind, randomized controlled trial of infants <32 weeks' gestation and/or <1501 g birth weight. Supplemented infants received additional intramuscular vitamin A 10 000 IU 3 times weekly from day 2 for a minimum of 2 weeks or until establishment of oral feeding. Hepatic stores were assessed by relative dose response (RDR). The primary outcome measure was cone-corrected dark-adapted retinal rod sensitivity measured by electroretinogram at 36 weeks' postmenstrual age (PMA).
Results:
Eighty-nine infants (42 supplemented and 47 controls) were recruited. Plasma retinol was higher in supplemented infants at 7 and 28 days (median, 1.0 vs 0.5 μmol/L and 0.7 vs 0.6 μmol/L; P < .001 and .03, respectively). Neither plasma retinol nor RDR differed between groups at 36 weeks' PMA. Retinal sensitivity was greater in supplemented infants (-0.81 vs -0.61 log cd • s • m(-2); P < .03) and was not related to RDR.
Conclusions:
Early high-dose intramuscular vitamin A supplementation for infants at risk of retinopathy of prematurity improves retinal function at 36 weeks' PMA.
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