To characterize clinical features, risk factors, and outcomes of vitamin A deficiency (VAD) among patients with gastrointestinal (GI) and/or hepatobiliary comorbidities, highlighting its significance in clinical practice.
Key Findings:
26 eyes from 13 patients were included, with common comorbidities being fatty liver disease (38.5%), prior gastric bypass (23.1%), and cirrhosis (23.1%).
Median serum vitamin A level at diagnosis was 19.1 mcg/dL, significantly below the reference range (38–72 mcg/dL).
84.6% of eyes showed anterior segment manifestations, with 15.4% presenting with bilateral corneal ulceration and perforation.
61.5% of eyes had posterior segment findings, including subretinal drusenoid deposits and optic neuropathy.
All patients reported bilateral vision loss, with 63.6% experiencing nyctalopia.
All patients who underwent vitamin A repletion experienced subjective visual improvement and resolution of ophthalmic findings, with median presenting best visual corrected acuity (BCVA) of 20/50 (logmar 0.44, range, 20/20-light perception).
Interpretation:
Vitamin A deficiency is prevalent in patients with GI and hepatobiliary diseases, leading to significant ocular manifestations that can improve with timely repletion, emphasizing the need for early screening.
Limitations:
Retrospective nature may limit the ability to establish causation and introduce potential biases.
Small sample size may not represent broader patient populations.
Conclusion:
Vitamin A deficiency is associated with diverse ocular findings in patients with GI and hepatobiliary disorders. Early identification and repletion can prevent irreversible ocular damage, underscoring the importance of routine screening.
