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Documenta Ophthalmologica

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01-06-2015 | Clinical Case Report

Electrophysiological and microperimetry changes in vitamin A deficiency retinopathy

Authors: Saker Saker, Marco Morales, Harsimar Jhittay, Yaqin Wen, Winfried Amoaku

Published in: Documenta Ophthalmologica | Issue 3/2015

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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Title: Electrophysiological and microperimetry changes in vitamin A deficiency retinopathy
Authors: Saker Saker
Marco Morales
Harsimar Jhittay
Yaqin Wen
Winfried Amoaku
Publication date: 01-06-2015
Publisher: Springer Berlin Heidelberg
Published in: Documenta Ophthalmologica / Issue 3/2015
Print ISSN: 0012-4486
Electronic ISSN: 1573-2622
DOI: https://doi.org/10.1007/s10633-015-9484-z

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Electrophysiological and microperimetry changes in vitamin A deficiency retinopathy

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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