Effects of Early Vitamin A Supplementation on the Risk for Retinopathy of Prematurity in Extremely Preterm Infants
Status:
Completed
Trial end date:
2017-12-31
Target enrollment:
Participant gender:
Summary
Retinopathy of prematurity (ROP) is a common retinal neovascular disorder and major cause of
vision impairment or blindness, despite current treatment of late stage ROP. Because the
visual disorders after treatment are often poor, preventive therapy for ROP is still lacking.
Although ROP is a multifactorial disease, the altered regulation of vascular endothelial
growth factor (VEGF) and insulin-like growth factor (IGF-1) have been implicated in the
pathogenesis of ROP. Vitamin A is one of the most important micronutrients affecting the
health of children. Supplementing newborn infants with vitamin A within the first 2 days of
life reduced infant mortality by almost 25%, with the greatest benefit to those of low birth
weight. Vitamin A has been used in this population prophylactically for chronic lung disease
with the large doses and no reported significant adverse effect exists. It is suggested that
vitamin A-retinoids and their active metabolite, retinoic acid (RA) have highly potent
antiangiogenic activity by inhibiting VEGF expression. Vitamin A (retinol) is converted into
retinoic acid in cells. However, the significance of Vitamin A administration has not been
investigated to our knowledge in an experimental ROP infant. The aim of this study was to
perform prospective, multicenter, randomized design to demonstrate the preventive effect of
Vitamin A on ROP.