Vitamin A Deficiency

A 73-year-old woman with a past medical history significant for Crohn’s disease and recently diagnosed colon cancer with recent sigmoid colon resection, presented with ten days of blurry vision in both eyes and nyctalopia. Onset of her symptoms was during a hospitalization for fungemia related to her chemotherapy port which was treated with IV amphotericin B. Neuro-ophthalmological exam was notable for a visual acuity of 20/80 in both eyes, reduced color vision, and macular mottling. Imaging was remarkable for thinning on ganglion cell layer OCT, constriction on Humphrey visual fields, and rod-cone dysfunction on full-field electroretinogram. Serum CAR anti-recoverin autoantibody testing was negative. Serum vitamin A was found to be extremely low. After initiation of vitamin A supplementation, the patient had rapid subjective improvement in her nyctalopia as well as improvement in her visual acuity and color vision testing.

Presentation Date: 08/06/2020

Issue Date: 01/22/2021