Ocular Manifestations of Ariboflavinosis

Abstract

JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org. This paper presents observations on ocular changes in a small group of patients known to be receiving insufficient riboflavin, and on the beneficial effects of riboflavin therapy on these lesions. From slitlamp examination and ocular signs the principal manifestation was found to be a keratitis. The corneal lesions improved or disappeared upon riboflavin therapy, and recurred on cessation of it. Two cases of keratitis associated with syphilis but resistant to antisyphilitic treatment were studied without attempting to control the diet. Riboflavin therapy appeared to be distinctly beneficial in these cases. OBSERVATIONS ON OCULAR LESIONS DUE TO ARIBOFLAVINOSISNine adults, 17 to 53 years of age, with ariboflavinosis were studied.Five were colored females, 3, white females, and 1, a wlhite nmale. All the patients had evidence of ariboflavinosis, both eye lesions anld other lesions. When first seen only 4 were free from othe,r (leficiency disease; 5 had signs of one or more other deficiency diseases. These were associated with ariboflavinosis in the following combinations: Avitaminosis C; pellagra; pellagra and avitaminosis A; pellagra, neuritis, and aniemia; pellagra, neuritis, anemia, and nutritional edema.As regards etiology, all gave a history of generally deficient diets; but 5 showed, in addition, other factors contributing to inadequate intake or to disturbance in utilization of nutrients. These factors were, respectively, colitis with diarrhea, sore tongue and diarrhea, sore tongue and self-imposed diet limitation, sore tongue and anorexia, and syphilis.During the period of observation, 6 patients were hospitalized and three were treated as out-patients. Hospitalized patients were maintained on a basal diet on which the oral lesions of ariboflavinosis were known to occur when supplemented with adequate amounts of other vitamins. Out-patients were advised not to change their home diets and to avoid yeast and cod-liver oil except as the latter was prescribed. The program in administering vitamin supplements was designed to demonstrate the lesions specific for aribofiavinosis and the sequence of changes in them. Most cases had multiple deficiency diseases calling for various supplements. First, there was administration of vitamins other than riboflavin, for they were not present in the basal diet in amounts sufficient for prompt and complete removal of other I In addition to funds supplied by the three organizations with which the authors are affiliated, facilities available to the University of Georgia M\edical School from a grant-in-aid by the John and Mery R. Markle Foundation also were used in the study.

Retbindin Is an Extracellular Riboflavin-binding Protein Found at the Photoreceptor/Retinal Pigment Epithelium Interface

“…However, these processes alone may not account for the high levels of flavins found in the retina. Despite their high levels in the retina, their concentration must be tightly regulated because riboflavin deficiency (ariboflavinosis) results in photosensitivity and poor dim light vision (43,44), although excess dietary riboflavin causes photoreceptor cell death via OS lipid peroxidation (45).…”

The Rapid Induction of Human Riboflavin Deficiency with Galactoflavin *

“…Corneal vascularization has been described in the riboflavin-deficient rat (33), in the galactoflavin-treated rat (34), and in endemic deficiencies in man (35)(36)(37)(38), which are usually complex deficiencies. It lias not been produced experimentally in man.…”

IV. Clinical nutrition in the United States.

“…27 Publication of the riboflavin studies was rapidly followed by many reports indicating that the disease was widespread. A recent summary of hundreds of reports from all parts of the world indicates that riboflavin deficiency is still one of the world's most prevalent vitamin deficiency diseases.…”