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Gantira Natadisastra, MD; John R. Wittpenn, MD; Keith P. West, Jr, DPH, RD; Muhilal, PhD; Alfred Sommer, MD

Arch Ophthalmol. 1987;105(9):1224-1228.

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.

Author Affiliations
From the Cicendo Eye Hospital and University of Padjajaran, Bandung, Indonesia (Dr Natadisastra); the International Center for Epidemiologic and Preventive Ophthalmology, Dana Center of The Wilmer Institute and School of Hygiene and Public Health, The Johns Hopkins University, Baltimore (Drs Wittpenn, West, and Sommer); the Eye Research Institute of the Retina Foundation, Boston (Dr Wittpenn); and the Nutrition Research and Development Center, Bogor, Indonesia (Dr Muhilal).

Footnotes
Accepted for publication May 21, 1987.

Presented in part at the Annual Meeting of the Association for Research in Vision and Ophthalmology, Sarasota, Fla, April 29, 1986.

Reprint requests to Wilmer 120, The Johns Hopkins Hospital, Baltimore, MD 21205 (Dr Sommer).

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