Electrophysiological and microperimetry changes in vitamin A deficiency retinopathy
Abstract
Purpose To describe a follow-up case of vitamin A deficiency (VAD)-related retinopathy with macular involvement monitored with electroretinography and microperimetry. Methods Flash (ERG), pattern (PERG), and multifocal (mfERG) electroretinography were recorded in parallel with microperimetry before and during 7-month follow-up of vitamin A treatment on a 65-year-old man presented with a 1-year history of night blindness. The patient had undergone ileostomy procedure for Crohn's disease 14 years ago. His best corrected visual acuity was 6/6 in each eye. Fundus examination revealed macular and mid-peripheral yellow-white lesions compatible with drusen. Results Before treatment, PERG was reduced, and mfERG was reduced and delayed, worse in responses from the central rings. These results revealed evidence of bilateral macular and central cone dysfunction. The flash ERG showed reduced dark-adapted 0.01 ERG (rod response); a-wave of dark-adapted 3.0 and 10.0 ERG was normal but b-wave was reduced (negative configuration); light-adapted 3.0 ERG was slightly reduced. The flash ERG revealed evidence of bilateral generalised retinal dysfunction affecting the rod more than cone system. Microperimetry showed deep reduction in retinal sensitivity. Fixation stability was unstable with eccentric locus. During treatment, ERG and microperimetry demonstrated significant improvements. Fixation stability reached normal values after the third treatment week. Conclusions This case illustrates the importance of electrophysiological investigation in early VAD-related retinopathy detection correlated with microperimetry. Our findings indicate a more delayed central cone function recovery than that of generalised rod and cone function. There was a marked correlation between ERG and microperimetric changes.
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Vitamin A is needed for normal visual function, and vitamin A deficiency (hypovitaminosis A) results in visual dysfunction that is reversible with vitamin A supplementation.
“Vitamin A is needed for normal visual function and vitamin A deficiency (hypovitaminosis A) results in visual dysfunction that is reversible with vitamin A supplementation.”
From The Role of Vitamin A in Retinal Diseases (2022) · cites this paper as [80]
Vitamin A replacement results in improvement of retinal function as well as structure, but long-term deficiency can lead to permanent degeneration of photoreceptors.
“Vitamin A replacement results in improvement of retinal function as well as structure, however long-term deficiency can lead to permanent degeneration of photoreceptors [31,80,81,83,84,85,86,87,88,90].”
From The Role of Vitamin A in Retinal Diseases (2022) · cites this paper as [80]
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- Authors
- Saker, S., Morales, M., Jhittay, H., Wen, Y., & Amoaku, W.
- Affiliations
- University of Nottingham (GB)
- Nottingham University Hospitals NHS Trust (GB)
- Corresponding author
- Amoaku, Winfried
- Venue
- Documenta Ophthalmologica
- Published
- 2015-01-28
- Volume
- 130
- Issue
- 3
- Pages
- 231-240
- ISSN
- 0012-4486 (ISSN-L)
- 1573-2622
- OpenAlex
- W2094157359
- Cited by
- 13
- References
- 39
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 2 · 2022: 3 · 2021: 1 · 2019: 2 · 2017: 1 · 2016: 1 · 2015: 1
- FWCI
- 0.43
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Documenta Ophthalmologica (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Retinal Development and Disorders
- Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
- Health Sciences › Medicine › Ophthalmology › Drug-Induced Ocular Toxicity
- Keywords
- night blindness, electroretinogram, microperimetry, multifocal electroretinogram, pattern electroretinography, rod function, retinal sensitivity, vitamin A supplementation, Crohn's disease, ileostomy, drusen
- MeSH terms
- Administration, Oral, Aged, Crohn Disease, Dark Adaptation, Electroretinography, Humans, Ileostomy, Injections, Intramuscular, Male, Night Blindness, Photic Stimulation, Retina, Retinal Diseases, Visual Acuity, Visual Fields, Vitamin A, Vitamin A Deficiency, Vitamins, Photoreceptor Cells, Vertebrate, Visual Field Tests
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