Clinical Report: Eye-related symptoms of vitamin A deficiency in patients with gastrointestinal and hepatobiliary disorders
Overview
This study characterizes the clinical features and outcomes of vitamin A deficiency (VAD) in patients with gastrointestinal and hepatobiliary disorders. It highlights the diverse ocular manifestations and the positive impact of vitamin A repletion on visual symptoms.
Background
Vitamin A is crucial for visual function and ocular health, with deficiency leading to significant ocular pathology. Patients with gastrointestinal and hepatobiliary diseases are particularly vulnerable to VAD due to impaired absorption and storage of this essential nutrient. Understanding the ocular manifestations of VAD in these populations is vital for timely diagnosis and treatment.
Data Highlights
Parameter
Value
Median serum vitamin A level at diagnosis
19.1 mcg/dL (range, 2.5–36.1 mcg/dL)
Median presenting best visual corrected acuity (BCVA)
20/50
Percentage of eyes with anterior segment manifestations
84.6%
Percentage of patients reporting nyctalopia
63.6%
Key Findings
Vitamin A deficiency was observed in patients with fatty liver disease, gastric bypass surgery, and cirrhosis.
84.6% of eyes showed anterior segment manifestations, including corneal ulceration.
61.5% of eyes had posterior segment findings, such as subretinal drusenoid deposits and optic neuropathy.
All patients reported bilateral vision loss, with a significant proportion experiencing nyctalopia.
Vitamin A repletion led to subjective visual improvement and resolution of ocular findings.
Clinical Implications
Recommend specific screening protocols for serum vitamin A levels in at-risk patients.
Conclusion
Vitamin A deficiency is a significant concern in patients with GI and hepatobiliary disorders, leading to diverse ocular symptoms. Timely diagnosis and treatment can prevent irreversible vision loss.
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