Teng Rhea W, Heidary Gena, Gise Ryan A
Department of Ophthalmology, Boston Children's Hospital, 300 Longwood Ave, Fegan 4, Boston, MA, 02115, USA.
Department of Ophthalmology, Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA.
Am J Ophthalmol Case Rep. 2024 Dec 10;37:102234. doi: 10.1016/j.ajoc.2024.102234. eCollection 2025 Mar.
Nutritional deficiencies in developed countries are a rare but potentially intervenable cause of optic neuropathy in pediatric populations. To date, much of the literature on nutritional optic neuropathy has focused on children with developmental delay, however, a growing body of evidence supports other underreported risk factors.
We describe three pediatric patients with normal neurodevelopment, who presented with decreased vision and were subsequently found to have optic neuropathy attributed to vitamin deficiencies, predominantly vitamin B12. We review previous literature on nutritional optic neuropathy in pediatric patients, revealing that most published cases were associated with autism (17/25, 68 %).
An increasing number of cases, including our own, describe patients without autism who develop nutritional optic neuropathy due to restricted diets related to traumatic food-related events, multiple food allergies, or from an unknown cause. Altogether, our findings highlight the importance of a thorough diet and allergy review in pediatric patients with optic atrophy.
在发达国家，营养缺乏是儿童视神经病变的罕见但可能可干预的病因。迄今为止，关于营养性视神经病变的许多文献都集中在发育迟缓的儿童身上，然而，越来越多的证据支持其他未被充分报道的风险因素。
我们描述了三名神经发育正常的儿科患者，他们出现视力下降，随后被发现患有因维生素缺乏（主要是维生素B12）导致的视神经病变。我们回顾了以往关于儿科患者营养性视神经病变的文献，发现大多数已发表的病例与自闭症有关（17/25，68%）。
越来越多的病例，包括我们自己的病例，描述了没有自闭症的患者，他们因与创伤性食物相关事件、多种食物过敏或不明原因相关的饮食限制而患上营养性视神经病变。总之，我们的研究结果强调了对患有视神经萎缩的儿科患者进行全面饮食和过敏评估的重要性。
