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Dark adaptation in vitamin A-deficient adults awaiting liver transplantation: improvement with intramuscular vitamin A treatment
  1. Winsome J Abbott-Johnson1,
  2. Paul Kerlin2,
  3. Ghassan Abiad3,
  4. Alan E Clague4,
  5. Ross C Cuneo5
  1. 1Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Australia
  2. 2Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia
  3. 3Department of Ophthalmology, Prince of Wales Hospital, Sydney, Australia
  4. 4Queensland Health Pathology Service, Brisbane, Australia
  5. 5Department of Medicine, University of Queensland, Brisbane, Australia
  1. Correspondence to Dr W J Abbott-Johnson, Department of Nutrition and Dietetics, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Qld 4102 Australia; winsome{at}universal.net.au

Abstract

Background/aims Although vitamin A deficiency is common in chronic liver disease, limited data exist on impairment of dark adaptation and response to therapy. The aims were (1) to assess dark adaptation in patients, (2) to assess the relationship between dark adaptation and vitamin A status, zinc and Child–Pugh score, (3) to compare perceived and measured dark adaptation and (4) to assess the dark adaptation response to intramuscular vitamin A.

Methods This was a prospective study of 20 patients (alcoholic liver disease 10, other parenchymal diseases six, cholestatic diseases four) awaiting liver transplantation. Selection was based on low serum retinol. There were 15 age-matched controls. Dark adaptation was measured with a SST-1 dark adaptometer and perception by questionnaire. Eight patients received 50 000 IU of retinyl palmitate, and dark adaptation was repeated at 1 month.

Results Forty per cent of patients had impaired dark adaptation. Patients with alcoholic liver disease were more impaired than those with other parenchymal diseases (p=0.015). No relationship was found between dark adaptation and the biochemical indicators or Child–Pugh score. Seventy-five per cent of patients with impairment did not perceive a problem. After intervention, light of half the previous intensity could be seen (p=0.05).

Conclusions Dark-adaptation impairment was common, was worse in alcoholic liver disease, was largely not appreciated by the patients and improved with vitamin A treatment.

  • Vision
  • biochemistry
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Footnotes

  • Funding WJA-J was supported by a Special Graduate School Scholarship, University of Queensland.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval Ethics approval was provided by the Princess Alexandra Hospital Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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