|
1
|
Maudgil A, Rachdan D, Khan MS, Siddiqui A, Hazrati LN, Richards MD, Najm-Tehrani N, Ali A. Bitot-like spots in children with normal vitamin A levels. Eye (Lond) 2022; 36:1896-1899. [PMID: 34531553 PMCID: PMC9499931 DOI: 10.1038/s41433-021-01569-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 02/25/2021] [Accepted: 04/20/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND/AIMS A Bitot spot is a conjunctival lesion, classically associated with severe vitamin A deficiency. In this paediatric series, we describe conjunctival lesions indistinguishable from Bitot spots, seen in the presence of normal vitamin A levels. METHODS This descriptive case series was performed by retrospective review of case notes, including all patients with Bitot-like spots found to have normal serum vitamin A levels, seen at the Hospital for Sick Children, Toronto, between 2006 and 2016. Data collected included age at presentation, ophthalmic and systemic diagnoses, and the presence of recognised genetic mutations. Histopathology was reviewed in one case. RESULTS Ten patients with Bitot-like spots with laboratory-confirmed normal serum vitamin A levels were identified. The conjunctival lesions were indistinguishable clinically and histopathologically from classic Bitot spots and were noted to occur in a range of anterior segment pathologies, including aniridia, WAGR syndrome, Axenfeld-Rieger syndrome, and blepharokeratoconjunctivitis. CONCLUSIONS Bitot-like spots are found in children with a number of anterior segment pathologies in the absence of vitamin A deficiency.
Collapse
Affiliation(s)
- Anu Maudgil
- Department of Ophthalmology and Vision Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- Department of Ophthalmology and Vision Sciences, Hospital for Sick Children, Toronto, ON, Canada.
- Department of Ophthalmology, Sheffield Children's Hospital, Sheffield, UK.
| | - Diyaa Rachdan
- Department of Ophthalmology and Vision Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Ophthalmology and Vision Sciences, Hospital for Sick Children, Toronto, ON, Canada
- Ophthalmology Division, Department of Surgery, Sidra Medicine, Doha, Qatar
- Weill Cornell Medicine, Al Luqta St, Qatar
| | - Muhammad Saad Khan
- Department of Ophthalmology and Vision Sciences, Hospital for Sick Children, Toronto, ON, Canada
| | - Amir Siddiqui
- Department of Ophthalmology and Vision Sciences, Hospital for Sick Children, Toronto, ON, Canada
| | - Lil-Naz Hazrati
- Department of Paediatric Laboratory Medicine, Hospital for Sick Children, Toronto, ON, Canada
| | - Michael D Richards
- Department of Ophthalmology and Vision Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Ophthalmology and Vision Sciences, Hospital for Sick Children, Toronto, ON, Canada
- Department of Ophthalmology, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Nasrin Najm-Tehrani
- Department of Ophthalmology and Vision Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Ophthalmology and Vision Sciences, Hospital for Sick Children, Toronto, ON, Canada
| | - Asim Ali
- Department of Ophthalmology and Vision Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Ophthalmology and Vision Sciences, Hospital for Sick Children, Toronto, ON, Canada
| |
Collapse
|