PEDIATRICS Vol. 73 No. 2 February 1984, pp. 238-249
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Retrolental Fibroplasia and Vitamin E in the Preterm Infant—Comparison of Oral Versus Intramuscular:Oral Administration

Helen M. Hittner MD1, Michael E. Speer MD1, Arnold J. Rudolph MD1, Cindy Blifeld MD1, Prabhujeet Chadda MD1, M. E. Blair Holbein PhD1, Louis B. Godio OD, PhD1, and Frank L. Kretzer PhD1

1 From the Cullen Eye Institute and Department of Pediatrics, Baylor College of Medicine, Houston

To evaluate the efficacy of four early intramuscular injections of vitamin E given in addition to continuous minimal oral vitamin E supplementation, 168 very low-birth-weight infants (le1,500 g) have enrolled in a randomized, double-masked, clinical study. All infants received vitamin E orally, 100 mg/kg/d. In addition, on days 1, 2, 4, and 6, seventy-nine infants received vitamin E intramuscularly, 15, 10, 10, and 10 mg/kg, respectively. On the same days, 89 control infants received placebo intramuscular injections. Multivariate analysis of the 135 infants who survived ge10 weeks showed no significant difference in the development of severe retrolental fibroplasia between these two supplementation schedules (P = .86). Plasma vitamin E levels never exceeded a mean of 3.3 mg/100 mL, and no toxicity was observed. Ultrastructural analyses of seven pairs of whole eye donations from infants receiving IM vitamin E demonstrated identical kinetics of gap junction formation between adjacent spindle cells as compared with 13 pairs of whole eye donations from control infants (P > .3). Therefore, oral vitamin E supplementation affords retinal protection against the development of severe retrolental fibroplasia when initiated on the first day of life and maintained continuously until retinal vascularization is complete.

Key Words: retrolental fibroplasia • retinal spindle cells (inducers of retrolental fibroplasia) • prophylactic • vitamin E protocols (IM:oral v oral) • vitamin E toxicity v efficacy

Submitted on August 5, 1983
Accepted on October 11, 1983




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[Abstract] [PDF]