Singer James R, Bakall Benjamin, Gordon Grant M, Reddy Rahul K
Associated Retina Consultants, 1750 East Glendale Avenue, Phoenix, AZ, 85020, USA.
University of Arizona College of Medicine, Phoenix, AZ, USA.
Doc Ophthalmol. 2016 Apr;132(2):137-45. doi: 10.1007/s10633-016-9533-2. Epub 2016 Mar 15.
To report treatment of vitamin A deficiency retinopathy with sublingual vitamin A drops.
Case report with review of the literature.
A 69-year-old Caucasian woman with a history of small bowel resection presented with progressive symptoms of bilateral nyctalopia and decreased visual acuity. Ophthalmic examination revealed bilateral conjunctival xerosis and fine white granular deposits in the midperipheral retina suggestive of vitamin A deficiency. Full-field electroretinogram (ERG), multifocal ERG (mfERG), and two-color dark adaptometry revealed significant impairment of rod and cone photoreceptor function. Kinetic perimetry demonstrated depressed macular sensitivity with constriction of the finer isopters. After 5 months of treatment with sublingual vitamin A drops, the patient's vision, ERG, mfERG, dark adaptometry, and perimetry normalized. A review of the literature summarizing the electrophysiologic testing in vitamin A deficiency is also discussed.
This case highlights novel observations on the effects of sublingual vitamin A supplementation for acquired vitamin A deficiency retinopathy. Sublingual vitamin A may represent a viable and efficacious treatment modality for vitamin A deficiency.
报告用舌下含服维生素A滴剂治疗维生素A缺乏性视网膜病变。
病例报告并复习文献。
一名69岁有小肠切除术病史的白种女性，出现进行性双侧夜盲和视力下降症状。眼科检查发现双侧结膜干燥，视网膜中外周有细小白色颗粒状沉积物，提示维生素A缺乏。全视野视网膜电图（ERG）、多焦ERG（mfERG）和双色暗适应测定显示杆状和锥状光感受器功能严重受损。动态视野检查显示黄斑敏感度降低，较细等视线收缩。在用舌下含服维生素A滴剂治疗5个月后，患者的视力、ERG、mfERG、暗适应测定和视野检查恢复正常。还讨论了一篇总结维生素A缺乏症电生理检测的文献综述。
本病例突出了舌下补充维生素A对获得性维生素A缺乏性视网膜病变影响的新观察结果。舌下含服维生素A可能是治疗维生素A缺乏的一种可行且有效的治疗方式。
