2 · Matrix, regenerative agents & supportive devices
Vitamin A (retinol / retinoic acid) — topical / systemic
Review — modulators of corneal healing › 2 · Matrix, regenerative agents & supportive devices › Vitamin A (retinol / retinoic acid) — topical / systemic
Vitamin A (retinol / retinoic acid) — topical / systemic
Retinyl palmitate ointment (VitA-POS); systemic retinol (for deficiency)
Oxford I (systemic) · II (topical)
Strong (deficiency)
Present · classic
Mechanism of actionNuclear RAR/RXR receptors → epithelial differentiation, goblet (mucus) cell density, prevention of squamous metaplasia/keratinization. Deficiency → xerophthalmia, keratomalacia. Topically: accelerates re-epithelialization and supports the mucin layer.
IndicationsVitamin A deficiency / xerophthalmia / keratomalacia (systemic, sight-saving); severe dry eye, cicatricial conjunctivitis, burns with keratinization, post-PRK (adjunct).
Route & dosageSystemic (WHO xerophthalmia protocol): retinol 200,000 IU on days 1, 2, and 14 (adjusted in children). Topical: retinyl palmitate ointment 1–4×/day.
Level of evidenceOxford I (systemic, deficiency — RCT/WHO); II (topical, ocular surface) · Scale: Strong (deficiency) / Moderate–Weak (topical, outside deficiency).
| FDA | Systemic vitamin A approved (WHO essential medicine); topical ocular formulation not approved as a dedicated wound-healing agent (compounded/adjunct use). |
|---|---|
| EU MA | Systemic form available; retinyl ocular ointments available (compounded preparations/OTC). |
| France | VitA-POS and equivalents widely used; systemic retinol available. |
| USA | Systemic form available; topical formulation compounded. |
| Asia | Generic, available. |
Key studies: RCT of topical vitamin A post-PRK — PMID 24109170 ; "Role of vitamin A on the ocular surface," Exp Eye Res — PMID 39581361 ; Tseng (topical retinoids, historical).