Abstract
Purpose: To identify and document the earliest diagnostic sign of vitamin Adeficiency (Imtiaz's sign).Material and Methods: This prospective case series study was conducted fromSeptember 1999 to September 2014 at ophthalmology department Chandkamedical college and Syed eye clinic, Larkana, Pakistan. Patients identifiedclinically as cases of hypovitaminosis A on the basis of presence of “Imtiaz’ssign” were included in the study. Patients with Retinitis pigmentosa, glaucoma,chronic liver disease and malabsorption syndrome were excluded from thestudy. Imtiaz's sign of vitamin A deficiency and nyctalopia were noted andrelevant laboratory investigations available were also done on selected patients.Patients were given therapeutic doses of vitamin A and improvement wasobserved to see resolution of Imtiaz’s sign of vitamin A deficiency and remissionof nyctalopia.Results: 650 patients, 152 (23.38%) males and 498 (76.62%) females wereidentified as cases of hypovitaminosis A on the basis of presence of Imtiaz’ssign. Age of the patients ranged from 5 to 43 years and the mean age (±standard deviation) was 18.15 ± 10.20 years. All patients replied positively fornyctalopia; however other signs, except Imtiaz’s sign, were not observed due tothe early stage of vitamin A deficiency. Relevant laboratory investigations wereperformed on selected cases which showed that 45.68% of them had irondeficiency, 40.74% of them had hypoalbuminemia and 13.58% had disturbedLFTs. This shows that most of the patients suffering from vitamin A deficiencywere victims of malnourishment.Conclusion: Imtiaz’s sign is an early and effective clinical diagnostic sign toidentify vitamin A deficiency at an early phase. It requires no costly tools forapplication, is safe and can be easily recognized and treated by vitamin Asupplements. Such a diagnostic ocular sign is desirable to avoid morbidity andmortality related to vitamin A deficiency.Keywords: Blindness, Malnutrition, Vitamin A deficiency, Xerophthalmia.
Syed Imtiaz Ali Shah, Shujaat Ali Shah, Partab Rai, Shahid Jamal Siddiqui, , Safdar Ali Abbasi, Shabir Ahmad Bhutto. (2015) Assessment of �Imtiaz�s Sign� for Early Detection of Hypovitaminosis A, Pakistan Journal of Ophthalmology, Volume 31, Issue 3.
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