Menon K, Vijayaraghavan K
Am J Clin Nutr. 1980 Feb;33(2):218-20. doi: 10.1093/ajcn/33.2.218.
Two-hundred sixteen children with vitamin A deficiency were hospitalized in Hyderabad, India, between 1970 and 1977. Out of these, 22 died during hospitalization. Fifty-six children could be followed-up, of whom 32 had keratomalacia and 24 corneal xerosis. In the keratomalacia group, nine died of reasons attributable to severe protein-energy malnutrition within 3 to 4 months after discharge from the hospital, five became totally blind, nine monocularily blind, and nine had adequate vision, although four of these had leucomas. Of the blind children, no change in condition was noted in the 11 located 1 year after the initial 3 to 4 month follow-up period. Of the 24 children with corneal zerosis, two died within 3 months, 21 retained normal vision, and one had adequate vision with leucoma. The high death rate, i.e., 30% of the keratomalacia cases in this study helps to explain the low prevalence of keratomalacia observed in past and current community surveys. The high return to normalcy of vision in the corneal xerosis cases after proper treatment support the recommendation of treating all children with eye involvement before the keratomalacia state whenever possible, for greater assurance of subsequent eye improvement.
1970年至1977年间，216名维生素A缺乏的儿童在印度海得拉巴住院治疗。其中，22名儿童在住院期间死亡。56名儿童得到了随访，其中32名患有角膜软化症，24名患有角膜干燥症。在角膜软化症组中，9名儿童在出院后3至4个月内死于严重蛋白质 - 能量营养不良相关原因，5名儿童完全失明，9名儿童单眼失明，9名儿童视力正常，不过其中4名有角膜白斑。在最初3至4个月随访期后的1年，对11名失明儿童进行观察，其病情无变化。在24名患有角膜干燥症的儿童中，2名在3个月内死亡，21名儿童视力保持正常，1名儿童视力正常但有角膜白斑。本研究中角膜软化症病例的高死亡率，即30%，有助于解释过去和当前社区调查中观察到的角膜软化症低患病率。角膜干燥症病例经适当治疗后视力恢复正常的比例较高，这支持了尽可能在角膜软化症状态出现之前对所有有眼部病变的儿童进行治疗的建议，以便更有把握使后续眼部情况得到改善。
