EFFECT OF DEFICIENCY IN MAN 



symptoms, a superficial vascularisation of the cornea progressing to 

 severe interstitial keratitis. Rosacea keratitis was said to be improved 

 by treatment with riboflavine. Similar ocular lesions were reported 

 by H. C. Hou/i by Spies et al.'^* ^^ and by K. W. Cosgrove and P. L. 

 Day.i^ Spies et al}'^ treated patients who developed ocular disease 

 on diets deficient in riboflavine with intravenous injections of ribo- 

 flavine. Within forty-eight hours, there was subjective improvement 

 in all cases, with a decrease in the ocular vasodilatation, the photo- 

 phobia, and the corneal ulceration. The number of haemolytic staphy- 

 lococci, streptococci and xerosis bacilli in the exudate from the eyes 

 decreased. Although many of the patients had irreparable eye 

 dcimage, pain was relieved and vision was improved. 



According to M. K. Gregory, i* riboflavine deficiency was character- 

 ised by superficial invasion of the cornea by fine capillaries arising 

 from the apices of the marginal loops, whilst I. Mann ^^ observed 

 that an early sign of ariboflavinosis was the budding of new capillaries 

 from the apices of limbal loops with extensions on to the true cornea. 

 These were generally present around the whole circumference of the 

 cornea in both eyes, and should disappear after giving riboflavine. 



There appears to be considerable doubt as to the value of corneal 

 vascularisation as a diagnostic criterion of ariboflavinosis. H. R. 

 Sandstead^^ and L. Lehrfeld,^"^ for example, remarked that not all 

 types of corneal vascularisation could be cured by riboflavine, whilst 

 H. Scarborough ^^ showed that riboflavine had no effect on circum- 

 corneal injection, which is therefore not diagnostic of ariboflavinosis. 

 W. M. Fish ^^ showed that the corneal vascularisation in acne rosacea 

 was different from that in riboflavine deficiency and did not respond to 

 riboflavine. Tisdall et al.,^^ however, observed that the incidence of 

 corneal vascularisation in Royal Canadian Air Force personnel was 

 high, and varied with the riboflavine content of the diet ; moreover, 

 a proportion of the cases responded with decreased vascularisation on 

 administration of large doses of riboflavine. On the other hand, no 

 change in corneal vascularisation occurred with different levels of 

 riboflavine in the diet. Similar results were obtained with Royal Air 

 Force personnel, ^^ many of whom had corneal vascularisation in spite 

 of receiving a satisfactory diet, nor was the condition always improved 

 by giving additional riboflavine. Similarly, corneal vascularisation 

 was observed in a high proportion of patients, ^^ but only in a small 

 number of the cases did the condition appear to be due to riboflavine 

 deficiency and not all of these were cured by riboflavine. It there- 

 fore appears that corneal vascularisation is often, but by no means 

 always, associated with riboflavine deficiency, and may sometimes 

 be improved by riboflavine, although it frequently requires an addi- 

 tional factor. 



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