This Article  • References  • Full text PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (187)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Eliot L. Berson, MD; Bernard Rosner, PhD; Michael A. Sandberg, PhD; K. C. Hayes, DVM, PhD; Britain W. Nicholson, MD; Carol Weigel-DiFranco; Walter Willett, MD

Arch Ophthalmol. 1993;111(6):761-772.

Abstract
• Objective.
—To determine whether supplements of vitamin A or vitamin E alone or in combination affect the course of retinitis pigmentosa.

Design.
—Randomized, controlled, double-masked trial with 2x2 factorial design and duration of 4 to 6 years. Electroretinograms, visual field area, and visual acuity were measured annually.

Setting.
—Clinical research facility.

Patients.
—601 patients aged 18 through 49 years with retinitis pigmentosa meeting preset eligibility criteria. Ninety-five percent of the patients completed the study. There were no adverse reactions.

Intervention.
—Patients were assigned to one of four treatment groups receiving 15 000 IU/d of vitamin A, 15 000 IU/d of vitamin A plus 400 IU/d of vitamin E, trace amounts of both vitamins, or 400 IU/d of vitamin E.

Main Outcome Measure.
—Cone electroretinogram amplitude.

Results.
—The two groups receiving 15 000 IU/d of vitamin A had on average a slower rate of decline of retinal function than the two groups not receiving this dosage (P=.01). Among 354 patients with higher initial amplitudes, the two groups receiving 15 000 IU/d of vitamin A were 32% less likely to have a decline in amplitude of 50% or more from baseline in a given year than those not receiving this dosage (P=.01), while the two groups receiving 400 IU/d of vitamin E were 42% more likely to have a decline in amplitude of 50% or more from baseline than those not receiving this dosage (P=.03). While not statistically significant, similar trends were observed for rates of decline of visual field area. Visual acuity declined about 1 letter per year in all groups.

Conclusions.
—These results support a beneficial effect of 15 000 IU/d of vitamin A and suggest an adverse effect of 400 IU/d of vitamin E on the course of retinitis pigmentosa.

Author Affiliations
From the Berman-Gund Laboratory for the Study of Retinal Degenerations, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston.

Footnotes
Accepted for publication April 15, 1993.

The authors have no proprietary interest in the products described in this article.

Reprint requests to Berman-Gund Laboratory, Massachusetts Eye and Ear Infirmary, 243 Charles St, Boston, MA 02114 (Dr Berson).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

A Homozygous Missense Mutation in the IRBP Gene (RBP3) Associated with Autosomal Recessive Retinitis Pigmentosa
den Hollander et al.
IOVS 2009;50:1864-1872.
ABSTRACT | FULL TEXT  

Effects of Long-Term Administration of 9-cis-Retinyl Acetate on Visual Function in Mice
Maeda et al.
IOVS 2009;50:322-333.
ABSTRACT | FULL TEXT  

Pharmacological manipulation of gain-of-function and dominant-negative mechanisms in rhodopsin retinitis pigmentosa
Mendes and Cheetham
Hum Mol Genet 2008;17:3043-3054.
ABSTRACT | FULL TEXT  

Visual Acuity Is Related to Parafoveal Retinal Thickness in Patients with Retinitis Pigmentosa and Macular Cysts
Sandberg et al.
IOVS 2008;49:4568-4572.
ABSTRACT | FULL TEXT  

Accelerated Accumulation of Lipofuscin Pigments in the RPE of a Mouse Model for ABCA4-Mediated Retinal Dystrophies following Vitamin A Supplementation
Radu et al.
IOVS 2008;49:3821-3829.
ABSTRACT | FULL TEXT  

Activation of Bone Marrow-Derived Microglia Promotes Photoreceptor Survival in Inherited Retinal Degeneration
Sasahara et al.
Am. J. Pathol. 2008;172:1693-1703.
ABSTRACT | FULL TEXT  

A Novel Form of Transducin-Dependent Retinal Degeneration: Accelerated Retinal Degeneration in the Absence of Rod Transducin
Brill et al.
IOVS 2007;48:5445-5453.
ABSTRACT | FULL TEXT  

Dark Rearing Rescues P23H Rhodopsin-Induced Retinal Degeneration in a Transgenic Xenopus laevis Model of Retinitis Pigmentosa: A Chromophore-Dependent Mechanism Characterized by Production of N-Terminally Truncated Mutant Rhodopsin
Tam and Moritz
J. Neurosci. 2007;27:9043-9053.
ABSTRACT | FULL TEXT  

Ciliary neurotrophic factor (CNTF) for human retinal degeneration: Phase I trial of CNTF delivered by encapsulated cell intraocular implants
Sieving et al.
Proc. Natl. Acad. Sci. USA 2006;103:3896-3901.
ABSTRACT | FULL TEXT  

The Association between Visual Acuity and Central Retinal Thickness in Retinitis Pigmentosa
Sandberg et al.
IOVS 2005;46:3349-3354.
ABSTRACT | FULL TEXT  

High-Dosage Vitamin E Supplementation and All-Cause Mortality
Lim et al.
ANN INTERN MED 2005;143:152-152.
FULL TEXT  

Designing the Selenium and Vitamin E Cancer Prevention Trial (SELECT)
Lippman et al.
JNCI J Natl Cancer Inst 2005;97:94-102.
ABSTRACT | FULL TEXT  

Meta-Analysis: High-Dosage Vitamin E Supplementation May Increase All-Cause Mortality
Miller et al.
ANN INTERN MED 2005;142:37-46.
ABSTRACT | FULL TEXT  

A Naturally Occurring Mutation of the Opsin Gene (T4R) in Dogs Affects Glycosylation and Stability of the G Protein-coupled Receptor
Zhu et al.
J. Biol. Chem. 2004;279:53828-53839.
ABSTRACT | FULL TEXT  

Clinical Trial of Docosahexaenoic Acid in Patients With Retinitis Pigmentosa Receiving Vitamin A Treatment
Berson et al.
Arch Ophthalmol 2004;122:1297-1305.
ABSTRACT | FULL TEXT  

Further Evaluation of Docosahexaenoic Acid in Patients With Retinitis Pigmentosa Receiving Vitamin A Treatment: Subgroup Analyses
Berson et al.
Arch Ophthalmol 2004;122:1306-1314.
ABSTRACT | FULL TEXT  

Kinetics of Visual Field Loss in Usher Syndrome Type II
Iannaccone et al.
IOVS 2004;45:784-792.
ABSTRACT | FULL TEXT  

Cone and Rod ERG Phototransduction Parameters in Retinitis Pigmentosa
Tzekov et al.
IOVS 2003;44:3993-4000.
ABSTRACT | FULL TEXT  

Overview
Mackey
Br J Ophthalmol 2003;87:637-638.
FULL TEXT  

Paternal Uniparental Heterodisomy With Partial Isodisomy of Chromosome 1 in a Patient With Retinitis Pigmentosa Without Hearing Loss and a Missense Mutation in the Usher Syndrome Type II Gene USH2A
Rivolta et al.
Arch Ophthalmol 2002;120:1566-1571.
ABSTRACT | FULL TEXT  

Disease Progression in Patients with Dominant Retinitis Pigmentosa and Rhodopsin Mutations
Berson et al.
IOVS 2002;43:3027-3036.
ABSTRACT | FULL TEXT  

Quantitative Electroretinogram Measures of Phototransduction in Cone and Rod Photoreceptors: Normal Aging, Progression With Disease, and Test-Retest Variability
Birch et al.
Arch Ophthalmol 2002;120:1045-1051.
ABSTRACT | FULL TEXT  

Systemic Administration of Phenyl-N-tert-Butylnitrone Protects the Retina from Light Damage
Ranchon et al.
IOVS 2001;42:1375-1379.
ABSTRACT | FULL TEXT  

Evidence-Guided Ophthalmology
Fong and Ferris III
Arch Ophthalmol 2001;119:585-589.
ABSTRACT | FULL TEXT  

The Relationship between Opsin Overexpression and Photoreceptor Degeneration
Tan et al.
IOVS 2001;42:589-600.
ABSTRACT | FULL TEXT  

High doses of vitamin E in the treatment of disorders of the central nervous system in the aged
Vatassery et al.
Am. J. Clin. Nutr. 1999;70:793-801.
ABSTRACT | FULL TEXT  

Photopic Temporal Processing in Retinitis Pigmentosa
Felius and Swanson
IOVS 1999;40:2932-2944.
ABSTRACT | FULL TEXT  

Oral vitamins C and E as additional treatment in patients with acute anterior uveitis: a randomised double masked study in 145 patients
van Rooij et al.
Br J Ophthalmol 1999;83:1277-1282.
ABSTRACT | FULL TEXT  

Glial Cell Line-Derived Neurotrophic Factor Induces Histologic and Functional Protection of Rod Photoreceptors in the rd/rd Mouse
Frasson et al.
IOVS 1999;40:2724-2734.
ABSTRACT | FULL TEXT  

Safety of <7500 RE (<25000 IU) vitamin A daily in adults with retinitis pigmentosa
Sibulesky et al.
Am. J. Clin. Nutr. 1999;69:656-663.
ABSTRACT | FULL TEXT  

Management of inherited outer retinal dystrophies: present and future
CHONG and BIRD
Br J Ophthalmol 1999;83:120-122.
FULL TEXT  

Effect of vitamin A supplementation on rhodopsin mutants threonine-17 right-arrow methionine and proline-347 right-arrow serine in transgenic mice and in cell cultures
Li et al.
Proc. Natl. Acad. Sci. USA 1998;95:11933-11938.
ABSTRACT | FULL TEXT  

Normal retina releases a diffusible factor stimulating cone survival in the retinal degeneration mouse
Mohand-Said et al.
Proc. Natl. Acad. Sci. USA 1998;95:8357-8362.
ABSTRACT | FULL TEXT  

Restrictive Strabismus After Ocular Surgery for Retinitis Pigmentosa in Cuba
Bacal et al.
Arch Ophthalmol 1997;115:930-931.
ABSTRACT  

Relationship Between Difficulty in Performing Daily Activities and Clinical Measures of Visual Function in Patients With Retinitis Pigmentosa
Szlyk et al.
Arch Ophthalmol 1997;115:53-59.
ABSTRACT  

Mechanisms of Photoreceptor Death in Retinal Degenerations: From the Cell Biology of the 1990s to the Ophthalmology of the 21 st Century?
Crane
Arch Ophthalmol 1996;114:1158-1158.
ABSTRACT  

Evaluation of Patients With Retinitis Pigmentosa Receiving Electric Stimulation, Ozonated Blood, and Ocular Surgery in Cuba
Berson et al.
Arch Ophthalmol 1996;114:560-563.
ABSTRACT  

The Cuban Experience: False Hope for a Cure for Retinitis Pigmentosa
Weleber
Arch Ophthalmol 1996;114:606-607.
ABSTRACT  

Digenic retinitis pigmentosa due to mutations at the unlinked peripherin/RDS and ROM1 loci
Kajiwara et al.
Science 1994;264:1604-1608.
ABSTRACT  

Vitamin A Supplementation for Retinitis Pigmentosa
Berson et al.
Arch Ophthalmol 1993;111:1456-1458.
ABSTRACT  

Vitamin A Supplementation for Retinitis Pigmentosa-Reply
Massof and Finkelstein
Arch Ophthalmol 1993;111:1458-1459.
ABSTRACT  

A Randomized Trial of Vitamin A and Vitamin E Supplementation for Retinitis Pigmentosa
Norton
Arch Ophthalmol 1993;111:1460-1460.
ABSTRACT  

A Randomized Trial of Vitamin A and Vitamin E Supplementation for Retinitis Pigmentosa
Clowes
Arch Ophthalmol 1993;111:1461-1462.
ABSTRACT  

A Randomized Trial of Vitamin A and Vitamin E Supplementation for Retinitis Pigmentosa
Gamel and Barr
Arch Ophthalmol 1993;111:1462-1463.
ABSTRACT  

A Randomized Trial of Vitamin A and Vitamin E Supplementation for Retinitis Pigmentosa
Fielder and Marshall
Arch Ophthalmol 1993;111:1463-1463.
ABSTRACT  

A Randomized Trial of Vitamin A and Vitamin E Supplementation for Retinitis Pigmentosa-Reply
Felix and Laties
Arch Ophthalmol 1993;111:1465-1466.
ABSTRACT  

A Randomized Trial of Vitamin A and Vitamin E Supplementation for Retinitis Pigmentosa
Marmor
Arch Ophthalmol 1993;111:1460-1461.
ABSTRACT  

A Randomized Trial of Vitamin A and Vitamin E Supplementation for Retinitis Pigmentosa-Reply
Berson et al.
Arch Ophthalmol 1993;111:1463-1465.
ABSTRACT  

Supplemental Vitamin A Retards Loss of ERG Amplitude in Retinitis Pigmentosa
Massof and Finkelstein
Arch Ophthalmol 1993;111:751-754.
ABSTRACT  

How Shall Research in the Treatment of Retinitis Pigmentosa Proceed?
Wong
Arch Ophthalmol 1993;111:754-756.
ABSTRACT  

Rapid restoration of visual pigment and function with oral retinoid in a mouse model of childhood blindness
Van Hooser et al.
Proc. Natl. Acad. Sci. USA 2000;97:8623-8628.
ABSTRACT | FULL TEXT