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老年患者维生素A缺乏症:年龄相关性黄斑变性时代的诊断挑战

Vitamin a Deficiency in an Elderly Patient: A Diagnostic Challenge in the Age of AMD.

作者信息

Pericak Jakob M, Chin Eric K, Almeida David R P

机构信息

State University of New York at Geneseo, Geneseo, NY, USA.

Erie Retina Research & Center for Advanced Surgical Exploration, Erie, PA, USA.

出版信息

Int Med Case Rep J. 2024 Oct 25;17:879-881. doi: 10.2147/IMCRJ.S472944. eCollection 2024.

Abstract

The presentation of vitamin A deficiency (VAD)-induced ocular complications can be challenging to diagnose in elderly patients, particularly due to the overlap with age-related macular degeneration (AMD) symptoms. This case report details the presentation, diagnosis, and management of an 88-year-old female with vision loss, highlighting the ocular manifestations of presumed VAD. Despite vitamin A levels being at the lower end of the normal range, the patient's symptoms and spectral domain optical coherence tomography (SD-OCT) findings suggested insufficient levels, leading to thinning of the outer nuclear layer. This case underscores the necessity of considering VAD in differential diagnoses of unexplained vision impairment, particularly in individuals with a history of intestinal malabsorption, while also emphasizing the importance of distinguishing VAD from AMD in elderly patients.

摘要

维生素A缺乏(VAD)引起的眼部并发症在老年患者中的表现可能难以诊断,特别是因为其与年龄相关性黄斑变性(AMD)症状存在重叠。本病例报告详细介绍了一名88岁视力丧失女性的临床表现、诊断和治疗,突出了疑似VAD的眼部表现。尽管维生素A水平处于正常范围的下限,但患者的症状和光谱域光学相干断层扫描(SD-OCT)结果提示水平不足,导致外核层变薄。该病例强调了在不明原因视力损害的鉴别诊断中考虑VAD的必要性,特别是在有肠道吸收不良病史的个体中,同时也强调了在老年患者中区分VAD和AMD的重要性。

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