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Erschienen in: Documenta Ophthalmologica 2/2024

24.01.2024 | Clinical Case Report

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

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

Erschienen in: Documenta Ophthalmologica | Ausgabe 2/2024

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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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Metadaten
Titel
Case of persistent corneal epithelial damage after cataract surgery leading to diagnosis of vitamin A deficiency
verfasst von
Fuyuki Yamada
Kumiko Kato
Ryunosuke Nagashima
Yuka Yonekawa
Yuzen Kashima
Mineo Kondo
Publikationsdatum
24.01.2024
Verlag
Springer Berlin Heidelberg
Erschienen in
Documenta Ophthalmologica / Ausgabe 2/2024
Print ISSN: 0012-4486
Elektronische ISSN: 1573-2622
DOI
https://doi.org/10.1007/s10633-023-09963-6

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