Case of persistent corneal epithelial damage after cataract surgery leading to diagnosis of vitamin A deficiency.

IF 2.6 4区医学 Q2 OPHTHALMOLOGY

Documenta Ophthalmologica Pub Date : 2024-04-01 Epub Date: 2024-01-24 DOI:10.1007/s10633-023-09963-6

Fuyuki Yamada, Kumiko Kato, Ryunosuke Nagashima, Yuka Yonekawa, Yuzen Kashima, Mineo Kondo

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引用次数: 0

Abstract

Purpose: To report our findings of reduced full-field electroretinograms (ff-ERGs) and abnormal optical coherence tomographic (OCT) images in a patient with poor visual acuity after cataract surgery who was eventually diagnosed with vitamin A deficiency (VAD).

Methods: This was a clinical study of a patient who complained of blurred vision after cataract surgery. To determine the cause of the reduced vision, we recorded full-field electroretinograms (ff-ERGs) to determine the scotopic and photopic status of the retina. We also performed optical coherence tomography to assess the changes in the retinal structure. Serological tests were performed.

Results: A 74-year-old man presented with persistent corneal epithelial damages and reduced vision that developed after conventional cataract surgery. OCT showed an interrupted ellipsoid zone, and fundus autofluorescence (FAF) showed a severe hypofluorescence in the retina of the left eye. The scotopic ff-ERGs were severely reduced, and the photopic ff-ERGs were mildly reduced. Serological examinations revealed a vitamin A concentration < 7 IU/dL (normal, 97-316 IU/dL). Based on these findings, we diagnosed the patient with VAD and started treatment with oral vitamin A supplements. After three months, his visual acuity, ff-ERGs, and OCT findings recovered to normal levels. The amplitudes and implicit times of the RETeval flicker ERGs increased to be within the normal range, and the hypofluorescence of the left eye disappeared. The length of the photoreceptor outer segments increased after the vitamin A supplementation.

Conclusion: Our findings indicate that the ERGs are helpful for diagnosing patients with VAD associated with persistent corneal epithelial damages.

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白内障手术后持续性角膜上皮损伤导致维生素 A 缺乏症的诊断病例。

目的：报告我们对一名白内障手术后视力不佳、最终被诊断为维生素 A 缺乏症（VAD）的患者进行全视场视网膜电图（ff-ERG）减弱和光学相干断层扫描（OCT）图像异常检查的结果：这是一项临床研究，研究对象是一名在白内障手术后主诉视力模糊的患者。为了确定视力下降的原因，我们记录了全视场视网膜电图（ff-ERG），以确定视网膜的散光和光感状态。我们还进行了光学相干断层扫描，以评估视网膜结构的变化。我们还进行了血清学检测：一名 74 岁的男子在传统白内障手术后出现持续性角膜上皮损伤和视力下降。OCT 显示椭圆形区中断，眼底自动荧光（FAF）显示左眼视网膜严重低荧光。左眼视网膜的散光虹膜ERG严重减弱，而光视虹膜ERG轻度减弱。血清学检查显示维生素 A 浓度为结论：我们的研究结果表明，ERGs 有助于诊断伴有持续性角膜上皮损伤的 VAD 患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Documenta Ophthalmologica 医学-眼科学

CiteScore

3.50

自引率

21.40%

发文量

审稿时长

>12 weeks

期刊介绍： Documenta Ophthalmologica is an official publication of the International Society for Clinical Electrophysiology of Vision. The purpose of the journal is to promote the understanding and application of clinical electrophysiology of vision. Documenta Ophthalmologica will publish reviews, research articles, technical notes, brief reports and case studies which inform the readers about basic and clinical sciences related to visual electrodiagnosis and means to improve diagnosis and clinical management of patients using visual electrophysiology. Studies may involve animals or humans. In either case appropriate care must be taken to follow the Declaration of Helsinki for human subject or appropriate humane standards of animal care (e.g., the ARVO standards on Animal Care and Use).