Conjunctival Impression Cytology in Vitamin A deficient children in a tertiary care hospital of Bihar: An observational, cross-sectional and comparative study

Abstract

Background: Subclinical Vitamin A deficiency gets missed on routine clinical and biochemical examination. In this study conjunctival impression cytology (CIC) was used as a diagnostic tool to screen subclinical cases and to examine children had history of night blindness with signs and symptoms of Vitamin A deficiency. Materials and methods: This was an observational, comparative and cross-sectional study on 100 children of all gender and age group between 3 to 12 years. Demographic profile, immunisation status, history of present illness and drug history, history of any disease in the last 6 months, detailed family and maternal history during pregnancy, clinical examination and laboratory investigations including conjunctival impression cytology were evaluated and compared between fifty Vitamin A deficient children and fifty normal and healthy children. Data were interpreted using Chi square (χ2) test and Fisher’s Exact test for significance by GraphPad Instat software. Relative risk was also calculated according to the comparative groups. Results: Study group versus control group, age group was 4-8 years (42%) vs 8-12 years (66%), 62% male preponderance vs same male & female ratio, had poor socio-economic conditions in 74% vs 52%, had immunization status 66% vs 90%, had history of infection in 54% vs 18% and had abnormal conjunctival impression cytology (CIC) in 90% vs 6% respectively. The relative risk between groups were statistically significant for different parameters. Abnormal conjunctival impression cytology found in 6% children in control group signifies that it is an important diagnostic tool for diagnosis of subclinical Vitamin A deficiency. Conclusion: Technique of conjunctival impression cytology can be used as a safe, non-invasive, cost effective method for screening of subclinical cases and also as a diagnostic tool to detect Vitamin A deficiency.