Prevalence of ocular manifestations of vitamin A deficiency in children: A systematic review.

Objective: Identify the prevalence of ocular manifestations due to vitamin A in children.

Methods: The systematic search was carried out in September 2022. Observational studies with populations between 0-18 years old, who had ocular manifestations due to vitamin A deficiency, were included. Studies with selected subjects with underlying diseases were excluded. The results were exported to the Rayyan tool for duplicate removal and paired reading. The methodological quality assessment of the included articles was carried out with the Agency for Healthcare Research and Quality Institute instrument.

Results: 79 studies published from 1972 to 2020 were included, carried out mainly in Asia 42 (53%) and Africa 28 (35.4%). In America, 4 studies were from Brazil; no research was found in Europe. The most reported ocular manifestations due to vitamin A were: xerophthalmia in 38.0% of the articles and night blindness in 69.6%, being more common in the general population (76.3%) and less in aborigines (1.9%). The diagnostic methods used were: surveys (82.3%), laboratory tests (32%), ocular evaluation by optometry or ophthalmologist (25.3%) and ocular examination by trained personnel (8.9%). The studies were carried out in the general population (79.7%), hospitals (15.2%), schools for the blind (2.5%), migrants in transit (1.3%) and aborigines (1.3%).

Conclusion: Ocular manifestations continue to represent a public health problem that affects children from 0 to 18 years of age on 4 continents, with greater emphasis on Asia and Africa. Additional studies are required to understand the impact of vitamin A deficiency in Latin America.