Jaggi Damian, Lincke Joel-Benjamin, Heussen Florian M, Unterlauft Jan D, Zinkernagel Martin S, Berger Lieselotte E
Department of Ophthalmology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Department of BioMedical Research, University of Bern, Bern, Switzerland.
Case Rep Ophthalmol. 2025 Feb 13;16(1):207-214. doi: 10.1159/000544701. eCollection 2025 Jan-Dec.
Retinal alterations in vitamin A deficiency have been described. The purpose of this study was to report a case of retinal alterations and choroidal thickening due to proven vitamin A deficiency.
We report a case of a 39-year-old woman who presented with progressing nyctalopia and mildly reduced visual acuity over a period of 1-2 years, despite being on oral vitamin A supplementation, following a history of gastric bypass and biliopancreatic diversion surgeries many years ago. Vitamin A levels were severely reduced (<0.1 µmol/L, reference range: 1.05-2.08 µmol/L). The outer retinal layers exhibited structural alterations and a reduction in thickness, while choroidal thickness was increased. The electroretinogram showed complete depletion of scotopic responses and a mild reduction in photopic responses. After intravenous vitamin A supplementation, complete resolution of both functional and structural changes was achieved.
This case highlights the importance of considering vitamin A deficiency even in patients receiving ongoing oral vitamin A supplementation, particularly if symptoms and clinical findings suggest its presence. Choroidal thickening and outer retinal thinning may provide further insights into the pathophysiology of this condition in future analyses.
维生素A缺乏导致的视网膜改变已有相关描述。本研究旨在报告一例因已证实的维生素A缺乏导致视网膜改变和脉络膜增厚的病例。
我们报告一例39岁女性病例，该患者在多年前接受胃旁路手术和胆胰转流手术后，尽管一直口服补充维生素A，但在1 - 2年的时间里仍出现进行性夜盲和轻度视力下降。维生素A水平严重降低（<0.1 μmol/L，参考范围：1.05 - 2.08 μmol/L）。视网膜外层出现结构改变且厚度变薄，而脉络膜厚度增加。视网膜电图显示暗视反应完全缺失，明视反应轻度降低。静脉补充维生素A后，功能和结构改变均完全恢复。
该病例强调了即使在持续口服补充维生素A的患者中也需考虑维生素A缺乏的重要性，特别是当症状和临床检查结果提示存在维生素A缺乏时。脉络膜增厚和视网膜外层变薄可能为未来分析该病症的病理生理学提供进一步的见解。
