VITAMIN A DEFICIENCY MONITORED BY QUANTITATIVE SHORT WAVELENGTH FUNDUS AUTOFLUORESCENCE IN A CASE OF BARIATRIC SURGERY

BACKGROUND/PURPOSE

Bariatric surgery is recognized as a treatment option for obesity. However, the cost-efficiency of screening for serum vitamin A and the effectiveness of its oral supplementation in these patients remain unclear. Here, we report a case in which vitamin A and carotenoid deficiency after bariatric surgery were monitored by noninvasive quantitative fundus autofluorescence imaging.

METHODS

Case report.

RESULTS

A 62-year-old man presented with a history of progressive night blindness. He had duodenal switch surgery 13 years earlier. One year before the initial visit, he had begun oral supplements of vitamins A. Short wavelength fundus autofluorescence images acquired for quantitative fundus autofluorescence revealed an intensity that was lower than the healthy-eye range. Scotopic rod-specific full-field electroretinograms were extinguished. These findings were consistent with vitamin A deficiency. The patient was given intramuscular vitamin A injections. At follow-up, quantitative fundus autofluorescence improved, ERG increased to normal, but macular pigment was unchanged.

CONCLUSION

Oral vitamin A supplementation may not be sufficient after mal-absorptive surgery and a quantitative and noninvasive short wavelength fundus autofluorescence imaging technique may be useful to monitor the status of vitamin A and the carotenoids comprising macular pigment in the retina.

Evaluation and Clinical Course of Keratomalacia With Descemetocele in a Child With Autism and Vitamin A Deficiency

Autistic children with selective diets have an elevated risk for vitamin A deficiency. The authors present the case of a 7-year-old boy with keratomalacia resulting from dietary vitamin A deficiency. Optical coherence tomography and ultrasound biomicroscopy can provide useful details of the cornea and underlying structures. Vitamin A supplementation can result in significant resolution, obviating the need for surgical intervention. [J Pediatr Ophthalmol Strabismus. 2020;57:e1-e3.].

[Mucoviscidosis: dysporia entero-broncho-pancreatica congenita familiaris (Glanzmann): Anderson syndrome (author's transl)]

The features of dysporia entero-broncho-pancreatica familiaris (mucoviscidosis) are described and the course of the disease over ten years is recounted. The cases are probably patients with true mucoviscidosis but in whom not all the symptoms develop in early childhood (Doerr). In the present case the symptoms only developed at the age of five years. From this time on there was increasing pancreatic insufficiency, chronic recurring bronchitis, with increasing destructive bronchitis and resulting respiratory insufficiency, dyspnoea and orthopnoea, right heart strain, sodium and chloride loss in the sweat, changes in the duodenum and the development of aganglionic megacolon.