Vitamin-A In Retinopathy Prevention: A Study on Preterm Babies

Background: Vitamin A -retinoids and their active metabolite, retinoic acid has highly potent antiangiogenic activity by inhibiting VEGF expression at the neovascularization phase. Objectives: To evaluate preventive effect of vitamin A on ROP. Materials and method: This randomized controlled trial study was conducted in the Neonatology Department of Dhaka Shishu Hospital among the preterm neonates of 32-34 completed weeks of gestation and also those neonates whose 1st ROP screening showed peripheral avascular zone irrespective of gestational age from July 2018 to June 2020. Initially 228 preterm neonates were enrolled in this study. Among them 164 preterm neonates were randomly allocated in vitamin A group (82) and control group (82). Vitamin A group received vitamin A drop perorally (5000 IU/Kg/day), added to their enteral feeds as soon as minimal feeding was introduced and continued from starting point to 4 weeks and dose of vitamin A also adjusted with multivitamin drop when vitamin A group had to be given multivitamin drop. Control group had been given multivitamin drop from 2 weeks of age. Out of these, 6 neonates died, 1 neonate shifted to another hospital and 9 neonates did not come for follow up after discharge. So finally, 148 neonates were completed this study. Results: Stage 1 ROP was equal in both groups in first follow up. In subsequent second and third follow up stage 2 ROP and stage 3 ROP was significantly higher in control group than vitamin A group (55.6% vs 23.7%) and (41.7% vs 19.7%) respectively. In terms of zones, zone-I ROP (which is worst condition) found significantly higher in control group than vitamin A group (56.9% vs 27.6%) in third follow up. In case of plus disease, at third follow up it had been found higher number in control group than vitamin A group (56.9% vs 27.6%). In overall it was found that incidence of ROP was reduced in vitamin A group in contrast to control group (32.9% vs 59.7%). In present study, rate of ROP 32.9% in vitamin A group and 59.7% in control group. Conclusion: Vitamin A supplementation prevents retinopathy of prematurity in preterm babies.