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Vitamin E supplementation and the retinopathy of prematurity
Insights
High-dose Vitamin E treatment significantly reduced legal blindness in infants with active retinopathy of prematurity. This intervention also increased the number of infants experiencing minimal visual morbidity, suggesting a beneficial role for Vitamin E.
Area of Science:
- Neonatal Ophthalmology
- Nutritional Science
- Pediatric Medicine
Background:
- Retinopathy of prematurity (ROP) is a leading cause of visual impairment in premature infants.
- Previous studies suggested a potential benefit of Vitamin E (E) in managing ROP.
- The role of Vitamin E in different stages of ROP requires further investigation.
Purpose of the Study:
- To evaluate the effect of high-dose Vitamin E treatment on visual morbidity in infants with active ROP.
- To assess the prophylactic effect of Vitamin E from birth on ROP severity and sequelae.
- To compare visual outcomes in infants with varying Vitamin E interventions and dietary factors.
Main Methods:
- A standardized scoring system assessed visual morbidity at one to two-year eye exams.
- High-dose Vitamin E (target serum levels 5-6 mg/dl) was administered to infants with 3-plus active ROP.
- Pilot studies investigated prophylactic Vitamin E (target serum levels 1.5 and 3.0 mg/dl) from birth.
- Historical comparison included infants fed early iron supplements and low E:PUFA ratio formulas.
Main Results:
- High-dose Vitamin E treatment reduced the incidence of legal blindness from 71% to 40% in infants with active ROP.
- The number of infants with minimal visual morbidity increased with Vitamin E treatment.
- Prophylactic Vitamin E from birth decreased mean ROP severity and sequelae.
- Significant differences in visual morbidity were observed between infants with varying Vitamin E interventions and dietary histories.
Conclusions:
- Vitamin E appears to exert a beneficial effect across all stages of retinopathy of prematurity.
- High-dose Vitamin E treatment is effective in reducing severe visual morbidity, including legal blindness.
- Vitamin E's regulatory role may contribute to its positive impact on ROP outcomes.
Abstract:
The effect of high-dosage E treatment (Rx) initiated at the stage of 3-plus active disease (target serum E levels, 5-6 mg/dl) was evaluated by a standardized scoring system of visual morbidity at the one to two year eye exam among infants cared for in the University of Pennsylvania Neonatal Complex (1976-1978). The incidence of legal blindness in both eyes or worse was decreased from 71 to 40% in E Rx (n = 10) as compared to non-E Rx (n = 14) infants, and the number of infants with minimal visual morbidity was increased. Pilot studies (1972-76; target serum E level, 1.5 and 3.0 mg/dl) of the prophylactic effect of E Rx from birth on showed a decrease in mean severity of acute stage disease and a decrease in sequelae at one to two years. A strikingly difference in visual morbidity following resolved low-grade ROP was seen when prestudy infants (1968-72) who were fed early iron supplements and given formulas with low E:PUFA ratios were compared to non-E Rx as well as to E Rx 1972-76 infants. Vitamin E seems to exert a beneficial effect at all stages of ROP, perhaps because of its broadly based regulatory role.