Treatment of vitamin A deficiency retinopathy with sublingual vitamin A palmitate

Purpose To report treatment of vitamin A deficiency retinopathy with sublingual vitamin A drops. Methods Case report with review of the literature. Results A 69-year-old Caucasian woman with a history of small bowel resection presented with progressive symptoms of bilateral nyctalopia and decreased...

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Bibliographic Details
Published in:Documenta ophthalmologica 2016-04, Vol.132 (2), p.137-145
Main Authors: Singer, James R., Bakall, Benjamin, Gordon, Grant M., Reddy, Rahul K.
Format: Article
Language:English
Subjects:
Administration, Sublingual
Aged
Clinical Case Report
Electroretinography
Female
Humans
Medicine
Medicine & Public Health
Night Blindness - drug therapy
Night Blindness - physiopathology
Ophthalmology
Retina - physiopathology
Visual Acuity - physiology
Visual Field Tests
Visual Fields - physiology
Vitamin A - administration & dosage
Vitamin A - analogs & derivatives
Vitamin A - blood
Vitamin A Deficiency - drug therapy
Vitamin A Deficiency - physiopathology
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Summary:Purpose To report treatment of vitamin A deficiency retinopathy with sublingual vitamin A drops. Methods Case report with review of the literature. Results A 69-year-old Caucasian woman with a history of small bowel resection presented with progressive symptoms of bilateral nyctalopia and decreased visual acuity. Ophthalmic examination revealed bilateral conjunctival xerosis and fine white granular deposits in the midperipheral retina suggestive of vitamin A deficiency. Full-field electroretinogram (ERG), multifocal ERG (mfERG), and two-color dark adaptometry revealed significant impairment of rod and cone photoreceptor function. Kinetic perimetry demonstrated depressed macular sensitivity with constriction of the finer isopters. After 5 months of treatment with sublingual vitamin A drops, the patient’s vision, ERG, mfERG, dark adaptometry, and perimetry normalized. A review of the literature summarizing the electrophysiologic testing in vitamin A deficiency is also discussed. Conclusions This case highlights novel observations on the effects of sublingual vitamin A supplementation for acquired vitamin A deficiency retinopathy. Sublingual vitamin A may represent a viable and efficacious treatment modality for vitamin A deficiency.
ISSN:0012-4486
1573-2622
DOI:10.1007/s10633-016-9533-2