International Journal of Retina and Vitreous (Jun 2020)

Outer retina changes on optical coherence tomography in vitamin A deficiency

  • Meghan K. Berkenstock,
  • Charles J. Castoro,
  • Andrew R. Carey

DOI
https://doi.org/10.1186/s40942-020-00224-1
Journal volume & issue
Vol. 6, no. 1
pp. 1 – 5

Abstract

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Abstract Background Vitamin A deficiency is rare in the United States and can be missed in patients with malabsorption syndromes without a high dose of suspicion. Ocular complications of hypovitaminosis A include xerosis and nyctalopia, and to a lesser extent reduction in visual acuity and color vision. Outer retinal changes, as seen on spectral domain optic coherence tomography (SD-OCT), in patients with vitamin A deficiency have previously not been documented. Case presentation We present two cases with symptoms of severe nyctalopia who were subsequently diagnosed with severe Vitamin A deficiency and their unique findings on SD-OCT of outer nuclear layer diffuse thinning with irregular appearance of the interdigitating zone and the ellipsoid zone as well as normalization after vitamin A supplementation. Conclusions Outer nuclear layer thinning and disruption of the outer retinal bands on SD-OCT are reversible with correction of vitamin A deficiency. Improvement in visual acuity, color vision, and nyctalopia are possible with early diagnosis and appropriate treatment.

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