Serum vitamin A levels in patients with ocular lesions attributable to non-complicated malaria in the Brazilian Amazon region.

In order to evaluate the association between serum vitamin A levels and ocular lesions attributable to non-complicated malaria, 200 patients seen consecutively at the Malaria Outpatient Clinic of FUNASA, Manaus, Amazonas, Brazil were included in this study. Ophthalmologic examination consisted of indirect binocular ophthalmoscopy under medicamentous mydriasis, biomicroscopy with a portable slit lamp and measurement of central visual acuity. Vitamin A serum concentration was determined by HPLC, and deficiency was defined as serum values equal to or lower than 0.35 micromol/l. Serum vitamin A values between 0.36 and 0.70 micromol/l were considered as marginal levels. Hypovitaminosis A (</=0.70 micromol/l serum levels) was observed in 33% (66/200) of the patients. Ocular lesions were associated with serum levels </=0.35 micromol/l (P < 0.001). Vitamin A deficiency was more frequent in patients with high parasitaemia (P = 0.029) and their first episode of malaria (P = 0.016). None of the patients showed clinical or ophthalmologic signs attributable to hypovitaminosis A.