Bhatnagar Anshul, Laylani Noor, Davila-Siliezar Pamela, Beaver Hilary A, Lee Andrew G
School of Medicine, Baylor College of Medicine, Houston, TX, USA.
Department of Ophthalmology, Blanton Eye Institute, Houston Methodist Hospital, Houston, TX, USA.
Case Rep Ophthalmol. 2024 Jul 15;15(1):559-564. doi: 10.1159/000537830. eCollection 2024 Jan-Dec.
Combined nutritional deficiency is an uncommon cause of vision loss in the USA. Notably, vitamin A deficiency can produce nyctalopia but rarely causes bilateral central vision loss. The combination of these symptoms is unusual, although likely underreported.
We report an exceptionally rare case of bilateral central vision loss and nyctalopia caused by combined vitamin A, zinc, and copper deficiency, likely following bariatric surgery and alcohol use. Following mineral and vitamin supplementation, the patient's vision improved significantly and returned to baseline within 1 month. Vision loss resulting from this specific multicombination of vitamin and mineral deficiency has never been reported previously in the English-language ophthalmic literature.
Given rising rates of bariatric surgery and alcohol use in the USA and abroad, clinicians should be aware that the combination of progressive nyctalopia and bilateral central vision loss may be produced by combined nutritional deficiency. Screening and supplementation of both vitamin and mineral deficiency may result in dramatic reversal of visual loss in such cases.
在美国，合并营养缺乏是视力丧失的罕见原因。值得注意的是，维生素A缺乏可导致夜盲，但很少引起双侧中心视力丧失。这些症状的组合并不常见，尽管可能存在报告不足的情况。
我们报告了一例极为罕见的双侧中心视力丧失和夜盲病例，病因是维生素A、锌和铜合并缺乏，可能继发于减肥手术后并伴有饮酒。补充矿物质和维生素后，患者视力显著改善，并在1个月内恢复到基线水平。这种特定的维生素和矿物质联合缺乏导致的视力丧失在英文眼科文献中此前从未有过报道。
鉴于美国国内外减肥手术和饮酒率不断上升，临床医生应意识到进行性夜盲和双侧中心视力丧失的组合可能是由合并营养缺乏引起的。对维生素和矿物质缺乏进行筛查和补充可能会使此类病例的视力丧失得到显著逆转。
