Ocular findings in cystic fibrosis patients receiving vitamin A supplementation
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J C Morkeberg1, C Edmund, J U Prause
1Department of Pediatrics, Cystic Fibrosis Center, State University Hospital, Copenhagen, Denmark.
Background:
Vitamin A deficiency with eye symptoms has been reported in patients with cystic fibrosis who received the recommended daily intake of vitamin A.
Methods:
We measured serum retinol, dark adaptation, contrast sensitivity, and dry eye status in 35 adult cystic fibrosis patients to ascertain whether they had ocular signs or symptoms.
Results:
Median serum retinol concentration was 1.95 mumol/l, range 1.08-4.01 mumol/l, with no values indicating vitamin A deficiency. Retinal light sensitivity was normal. Nineteen patients had reduced contrast sensitivity. Conjunctival imprints all showed plenty of goblet cells, but were characteristic of dry eye in 42% of patients (n = 14). Decreased tear film stability was found in 49% (n = 17), tear production was low in 31% (n = 11), and 23% (n = 8) showed an increased amount of dying epithelial cells. Nine patients (26%) had keratoconjunctivitis sicca according to the Copenhagen criteria.
Conclusion:
Our patients had no biochemical or clinical signs of vitamin A deficiency. We speculate that the high incidence of dry eye could be a primary manifestation of cystic fibrosis.