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Impression Cytology for Detection of Vitamin A Deficiency

Impression Cytology for Detection of Vitamin A Deficiency Abstract • Vitamin A (retinol) deficiency causes blindness, increased morbidity, and mortality among preschool children in many developing nations. Previous studies suggest that impression cytology may represent the first simple, reliable test to detect mild xerophthalmia in young children. We used impression cytology toevaluate and follow up 75 Indonesian preschool children with mild xerophthalmia and an equal number of age-matched, clinically normal neighborhood controls. Results of impression cytology, which were closely correlated with baseline serum vitamin A levels, documented histologic improvement following treatment with vitamin A. Furthermore, results of impression cytology, where abnormal, improved to normal following vitamin A treatment in a significant percentage (23%) of otherwise clinically normal children. Impression cytology appears to detect clinical and physiologically significant preclinical vitamin A deficiency. References 1. Sommer A, Tarwotjo I, Hussaini G, et al: Incidence, prevalence, and scale of blinding malnutrition . Lancet 1981;1:1407-1408.Crossref 2. Sommer A: Field Guide to the Detection and Control of Xerophthalmia , ed 2. Geneva, World Health Organization, 1982. 3. Sommer A: Nutritional Blindness: Xerophthalmia and Keratomalacia . New York, Oxford University Press Inc, 1982. 4. Sommer A, Katz J, Tarwotjo I: Increased risk of respiratory disease and diarrhea in children with preexisting mild vitamin A deficiency . Am J Clin Nutr 1984;40:1090-1095. 5. Sommer A, Tarwotjo I, Hussaini G, et al: Increased mortality in children with mild vitamin A deficiency . Lancet 1983;2:585-588.Crossref 6. Sommer A: Mortality associated with mild, untreated xerophthalmia . Trans Am Ophthalmol Soc 1983;81:825-853. 7. Sommer A, Tarwotjo I, West K, et al: Impact of vitamin A supplementation on childhood mortality: A randomized controlled community trial . Lancet 1986;1:1169-1173.Crossref 8. Wittpenn J, Tseng S, Sommer A: Detection of early xerophthalmia by impression cytology . Arch Ophthalmol 1986;104:237-239.Crossref 9. Arroyave G, Chichester CO, Flores H, et al: Biochemical Methodology for the Assessment of Vitamin A Status: A Report of the International Vitamin A Consultative Group . Washington, DC, Nutrition Foundation, 1982. 10. Tseng S: Staging of conjunctival squamous metaplasia by impression cytology . Ophthalmology 1985;92:728-733.Crossref 11. Pereira S, Begum A: Failure of a massive single oral dose of vitamin A to prevent deficiency . Arch Dis Child 1971;46:525-527.Crossref 12. Suthutvoravoot S, Olson J: Plasma and liver concentrations of vitamin A in a normal population of urban Thai . Am J Clin Nutr 1974;27:883-891. 13. Wolbach S, Howe P: Tissue changes following deprivation of fat-soluble A vitamin . J Exp Med 1925;42:753-777.Crossref 14. Mori S: Primary changes in eyes of rats which result from deficiency of fat-soluble A in diet . JAMA 1922;79:197-200.Crossref 15. Wilson J, DuBois R: Keratomalacia in infants with postmortem examination . AJDC 1923;26:431-436. 16. Blackfan K, Wolbach S: Vitamin A deficiency in infants: A clinical and pathological study . J Pediatr 1933;3:679-706.Crossref 17. Sweet L, K'ang H: Clinical and anatomic study of avitaminosis A among the Chinese . AJDC 1935;50:699-734. 18. Sommer A, Green W, Kenyon K: Bitot's spots responsive and nonresponsive to vitamin A: Clinicopathologic correlations . Arch Ophthalmol 1981;99:2019-2027. 19. Egbert P, Lauber S, Maurice D: A simple conjunctival biopsy . Am J Ophthalmol 1977;84:798-801. 20. Hatchell D, Sommer A: Detection of ocular surface abnormalities in experimental vitamin A deficiency . Arch Ophthalmol 1984;102:1389-1393.Crossref 21. Kessing S: Mucous gland system of the conjunctiva: A quantitative normal anatomical study . Acta Ophthalmol Suppl 1986;95:9-133. 22. Kenyon K, John T, Hanninen L, et al: Evaluation of conjunctival goblet cells in vitamin A-deficient rats by impression cytology and flat mount preparation . Invest Ophthalmol Vis Sci 1986;27( (suppl) ):27. 23. Sommer A, Hussaini G, Muhilal, et al: History of nightblindness: A simple tool for xerophthalmia screening . Am J Clin Nutr 1980;33:887-891. 24. Sommer A, Emran N, Tjakrasudjatma S: Clinical characteristics of vitamin A responsive and nonresponsive Bitot's spots . Am J Ophthalmol 1980;90:160-171. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Impression Cytology for Detection of Vitamin A Deficiency

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Publisher
American Medical Association
Copyright
Copyright © 1987 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1987.01060090082033
Publisher site
See Article on Publisher Site

Abstract

Abstract • Vitamin A (retinol) deficiency causes blindness, increased morbidity, and mortality among preschool children in many developing nations. Previous studies suggest that impression cytology may represent the first simple, reliable test to detect mild xerophthalmia in young children. We used impression cytology toevaluate and follow up 75 Indonesian preschool children with mild xerophthalmia and an equal number of age-matched, clinically normal neighborhood controls. Results of impression cytology, which were closely correlated with baseline serum vitamin A levels, documented histologic improvement following treatment with vitamin A. Furthermore, results of impression cytology, where abnormal, improved to normal following vitamin A treatment in a significant percentage (23%) of otherwise clinically normal children. Impression cytology appears to detect clinical and physiologically significant preclinical vitamin A deficiency. References 1. Sommer A, Tarwotjo I, Hussaini G, et al: Incidence, prevalence, and scale of blinding malnutrition . Lancet 1981;1:1407-1408.Crossref 2. Sommer A: Field Guide to the Detection and Control of Xerophthalmia , ed 2. Geneva, World Health Organization, 1982. 3. Sommer A: Nutritional Blindness: Xerophthalmia and Keratomalacia . New York, Oxford University Press Inc, 1982. 4. Sommer A, Katz J, Tarwotjo I: Increased risk of respiratory disease and diarrhea in children with preexisting mild vitamin A deficiency . Am J Clin Nutr 1984;40:1090-1095. 5. Sommer A, Tarwotjo I, Hussaini G, et al: Increased mortality in children with mild vitamin A deficiency . Lancet 1983;2:585-588.Crossref 6. Sommer A: Mortality associated with mild, untreated xerophthalmia . Trans Am Ophthalmol Soc 1983;81:825-853. 7. Sommer A, Tarwotjo I, West K, et al: Impact of vitamin A supplementation on childhood mortality: A randomized controlled community trial . Lancet 1986;1:1169-1173.Crossref 8. Wittpenn J, Tseng S, Sommer A: Detection of early xerophthalmia by impression cytology . Arch Ophthalmol 1986;104:237-239.Crossref 9. Arroyave G, Chichester CO, Flores H, et al: Biochemical Methodology for the Assessment of Vitamin A Status: A Report of the International Vitamin A Consultative Group . Washington, DC, Nutrition Foundation, 1982. 10. Tseng S: Staging of conjunctival squamous metaplasia by impression cytology . Ophthalmology 1985;92:728-733.Crossref 11. Pereira S, Begum A: Failure of a massive single oral dose of vitamin A to prevent deficiency . Arch Dis Child 1971;46:525-527.Crossref 12. Suthutvoravoot S, Olson J: Plasma and liver concentrations of vitamin A in a normal population of urban Thai . Am J Clin Nutr 1974;27:883-891. 13. Wolbach S, Howe P: Tissue changes following deprivation of fat-soluble A vitamin . J Exp Med 1925;42:753-777.Crossref 14. Mori S: Primary changes in eyes of rats which result from deficiency of fat-soluble A in diet . JAMA 1922;79:197-200.Crossref 15. Wilson J, DuBois R: Keratomalacia in infants with postmortem examination . AJDC 1923;26:431-436. 16. Blackfan K, Wolbach S: Vitamin A deficiency in infants: A clinical and pathological study . J Pediatr 1933;3:679-706.Crossref 17. Sweet L, K'ang H: Clinical and anatomic study of avitaminosis A among the Chinese . AJDC 1935;50:699-734. 18. Sommer A, Green W, Kenyon K: Bitot's spots responsive and nonresponsive to vitamin A: Clinicopathologic correlations . Arch Ophthalmol 1981;99:2019-2027. 19. Egbert P, Lauber S, Maurice D: A simple conjunctival biopsy . Am J Ophthalmol 1977;84:798-801. 20. Hatchell D, Sommer A: Detection of ocular surface abnormalities in experimental vitamin A deficiency . Arch Ophthalmol 1984;102:1389-1393.Crossref 21. Kessing S: Mucous gland system of the conjunctiva: A quantitative normal anatomical study . Acta Ophthalmol Suppl 1986;95:9-133. 22. Kenyon K, John T, Hanninen L, et al: Evaluation of conjunctival goblet cells in vitamin A-deficient rats by impression cytology and flat mount preparation . Invest Ophthalmol Vis Sci 1986;27( (suppl) ):27. 23. Sommer A, Hussaini G, Muhilal, et al: History of nightblindness: A simple tool for xerophthalmia screening . Am J Clin Nutr 1980;33:887-891. 24. Sommer A, Emran N, Tjakrasudjatma S: Clinical characteristics of vitamin A responsive and nonresponsive Bitot's spots . Am J Ophthalmol 1980;90:160-171.

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Sep 1, 1987

References