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Rafael C. Caruso, MD; JoAnne Zujewski, MD; Fumino Iwata, MD; Marvin J. Podgor, PhD; Barbara A. Conley, MD; Leanne M. Ayres, COA; Muriel I. Kaiser-Kupfer, MD

Arch Ophthalmol. 1998;116:759-763.

Objectives  To assess the alterations in dark adaptation induced by low (200 mg/d) doses of fenretinide (4-HPR), to assess whether these effects were cumulative and whether they were reversible, and to attempt to elucidate the mechanism underlying the changes in night vision.

Design  Case series.

Setting  Outpatient eye clinic.

Patients  Twenty-two women enrolled in a breast cancer chemoprevention trial, and 18 normal control subjects.

Intervention  Measurements of absolute luminance thresholds during dark adaptation.

Main Outcome Measures  Parameters of an exponential model of the dark-adaptation function before, during, and after administration of fenretinide.

Results  The most conspicuous effect of fenretinide on dark adaptation was a significant delay in the timing of the rod-cone break (P<.001). A minimal elevation of the final cone threshold was also observed. These effects were reversible after fenretinide therapy was discontinued and did not seem to be cumulative. An inverse relationship between delay of the rod-cone break and plasma retinol concentration was found.

Conclusion  The dose of fenretinide used in this study produced clearly measurable, but not severe, changes in night vision, which were rarely symptomatic.

From the Ophthalmic Genetics and Clinical Services Branch (Drs Caruso, Iwata, and Kaiser-Kupfer, and Ms Ayres) and the Statistical Methods and Analysis Section, Division of Biometry and Epidemiology (Dr Podgor), National Eye Institute, and the Medicine Branch, Division of Clinical Sciences (Dr Zujewski) and the Clinical Investigations Branch, Cancer Therapy Evaluation Program (Dr Conley), National Cancer Institute, National Institutes of Health, Bethesda, Md. Part of this study was completed while Dr Conley was with the Greenebaum Cancer Center and School of Medicine, University of Maryland, Baltimore.

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