Excess Vitamin A and Stargardt disease

Vitamin deficiency is a common problem and in some cases, having excess vitamin causes bigger problems. Due to excess Vitamin A, Stargardt disease is a very common condition diagnosed in children and young adults under the age of 20. This disease, which is an inherited disorder of the retina, turns into macular degeneration and eventually leads to legal blindness. In some cases, an individual with such disease may experience loss in vision in late adulthood. About 1 in 10,000 people inherit this Stargardt Disease, which is also termed as Stargardt macular dystrophy, juvenile macular degeneration, or fundus flavimaculatus.

In case of individuals with this specific condition, vitamin A builds up in one area of the eye and often it becomes toxic. In the retina there are two types of photoreceptors namely rod cells and cone cells. These photoreceptors are responsible for detecting light and converting into electrical signals. Human brain detects it and an individual can ‘see’ objects or surroundings.  The Rods and Cons have specific functions. Rod cells are found in outer retina of human eye and helps in dim and dark lighting. Cone cells are found in macula of human eye and helps in  fine visual detail and color. With Stargardt disease, both these photoreceptors die away and  cone cells are affected more strongly.

Diagnosis of Stargardt disease is indeed an important task which associates close examining of retina.  Often Lipofuscin deposits are found as yellowish flecks in the macular. Be it the number, size, colour and appearance of these specific flecks are different for different individuals suffering from Stargardt disease.  Other standardized tests like visual field testing, colour testing, clicking fundus photo, electroretinography (ERG), optical coherence tomography (OCT) are often used for positive diagnosis of Stargardt disease for concerned individuals. Interestingly, no treatment as such is available for Stargardt disease. There are specific medical advices for individuals with Stargardt disease. Wearing dark glasses and hats are essential to reduce accumulation of lipofuscin. Cigarette smoking has to be avoided and even passive smoking can be extremely detrimental. As far as dietary components are concerned, eating a healthy balanced diet in mandatory which includes fish, along leafy greens, a handful of nuts and low GI carbohydrates are necessary every week.

 Although it is a common advice to have Vitamin A supplements, still it is important to have optimum intake, strictly advised by the physician.  Counseling and occupational therapies are often considered to be part of the treatment plan along with low-vision aids. Many people become visuably disabled by their 20s due to Stargardt disease. Thus emotional support is also integral to possible rehabilitation of an individual.