Suan E P, Bedrossian E H, Eagle R C, Laibson P R
Oculoplastic Service, Wills Eye Hospital, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA.
Arch Ophthalmol. 1990 Mar;108(3):350-3. doi: 10.1001/archopht.1990.01070050048028.
An emaciated alcoholic 52-year-old white woman presented with an old left corneal perforation and bilateral conjunctival and corneal xerosis. The serum vitamin A level was 0 mumol/L. Laboratory and radiologic findings were consistent with the diagnosis of a fat malabsorptive syndrome secondary to chronic alcoholic pancreatitis. Histopathologic evaluation of her enucleated globe revealed conjunctival epidermidalization, corneal perforation with prolapse and loss of intraocular contents, retinal detachment, and massive choroidal hemorrhage. A second patient presented with bilateral conjunctival xerosis, corneal ulcers, and a low serum vitamin A level. Corneal perforation of one ulcer ensued during her hospitalization. Medical investigation revealed hepatic metastases of an unknown primary source. Causes of vitamin A deficiency and its ocular complications as well as medical and surgical management options are discussed.
一名52岁的消瘦白人女性酗酒者，出现陈旧性左眼角膜穿孔以及双侧结膜和角膜干燥症。血清维生素A水平为0微摩尔/升。实验室检查和影像学检查结果与慢性酒精性胰腺炎继发脂肪吸收不良综合征的诊断相符。对其摘除眼球的组织病理学评估显示结膜表皮化、角膜穿孔伴眼内容物脱垂和缺失、视网膜脱离以及大量脉络膜出血。另一名患者出现双侧结膜干燥症、角膜溃疡和低血清维生素A水平。住院期间，其中一个溃疡发生了角膜穿孔。医学检查发现有未知原发灶的肝转移。本文讨论了维生素A缺乏的病因及其眼部并发症，以及药物和手术治疗方案。
