Retinitis Pigmentosa Clinical Trial
To determine whether supplements of vitamin A or vitamin E alone or in combination affect the course of retinitis pigmentosa.
Retinitis pigmentosa (RP) is a group of inherited retinal degenerations with a worldwide
prevalence of about 1 in 4,000. Patients typically report night blindness in adolescence and
lose vision in the midperipheral followed by far-peripheral visual field in adulthood due to
progressive loss of both rod and cone function. Most patients have reductions in central
vision by age 50 to 80 years. Modern-day electroretinograms (ERGs) make it possible to
record retinal responses from most patients with remaining vision and thereby monitor
objectively the course of their disease.
While the natural course of retinal degeneration in the common forms of RP was being
studied, it was noted that a subgroup of patients aged 18 through 49 who were treating
themselves with both vitamin A and vitamin E and other nutritional supplements exhibited
less decline in ERG amplitude over a 2-year period. These preliminary findings, as well as
the known roles of vitamins A and E in maintaining normal photoreceptor function and
structure, prompted this randomized, controlled trial to determine whether these vitamins
alone or in combination would halt or slow the progression of the common forms of RP.
This study was a randomized, controlled double-masked trial with 2 x 2 factorial design and
duration of 4 to 6 years. Patients were assigned to one of four treatment groups:
15,000 IU/day vitamin A
15,000 IU/day vitamin A + 400 IU/day vitamin E
trace amounts of both vitamins A and E
400 IU/day of vitamin E
The main outcome measure was the 30-Hz cone ERG amplitude. In addition, visual field and
visual acuity were measured annually.
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Allocation: Randomized, Intervention Model: Factorial Assignment, Masking: Double-Blind, Primary Purpose: Treatment
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