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Xerophthalmia Classification by Ocular Signs

Xerophthalmia Classification by Ocular Signs

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Since the discovery of vitamin A as a fat-soluble growth factor in the early part of the century, research into carotenoids and retinoids has attracted the attention of many scientists. These two groups of compounds are still being actively studied all over the world since many gaps in knowledge exist and new frontiers are being pursued. Recent dev...

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... older designations for these isomers are given in brack­ ets. Both the biological activity (Table 7, Section VI. B) and physical propeJ1ies of retinol, retin­ aldehyde, and retinoic acid are highly dependent on their isomeric forms. ...
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... This was subsequently modified in another WHO meeting. 140 The clas­ sification is reproduced in Table 7. Following this, a brief description of the signs is givi~n. ...
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... Most of these publications include colored photographs of the ocular signs. With the exception of corneal scar (XS) and xerophthalmic fundus (XF), the ocular signs in Table 7 are arranged in increasing order of se­ verity of active vitamin A deficiency. However, this does not mean that all the earlier stages have necessarily occurred when a later stage is de­ tected. ...
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... earliest structural change in xerophthal­ mia is conjunctival xerosis (XIA in Table 7) con­ sisting of one or more patches of dry. nonwet­ table conjunctiva, with loss of transparency. ...
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... has, however, been pointed out that these latter signs are poorly reproducible, highly vari­ able, and nonspecific, and should not be used in isolation in making a diagnosis of XIA. 141 ),: 64 The xerosis process in X I A extends to the formation of Bitot's spots (XIB in Table 7), These are small plaques of a silvery gray hue, usually with a foamy surface, consisting of keratinized, desquamated conjunctival epithelial cells. XIB usually appears on the temporal quadrant of the conjunctival surface and may occur on one or both eyes . . ...
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... more serious, blinding effects of severe vitamin A deficiency involving the cornea consist in the early stages of xerosis, loss of transpar­ ency, and nonwettability, as in the conjunctiva, giving the cornea a hazy appearance (X2 in Table 7). Subsequent to X2, tt.ere is loss of continuity of the epithelium with forrnation of inflammatory "ulcer". ...
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... to X2, tt.ere is loss of continuity of the epithelium with forrnation of inflammatory "ulcer". Further progression of this corneal ul­ ceration, frequently referred to as keratomalacia (X3A and X3B in Table 7), may eventually end in impairment of vision to varying degrees. ...

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