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TitreObesity surgery and vitamin A deficiency: two cases.
ButWe present two patients with xerophtalmia, decreased vision and nyctalopia suffering from vitamin A deficiency. Before referral, their history of obesity surgery was considered irrelevant to ophthalmic complaints. However this type of surgery can be the cause of malabsorption of fat-soluble vitamin A, D, E and K. Vitamin A is the main constituent of rhodopsin which is present in the rods and cones of the retina, and of the epithelial cell RNA and glycoprotein synthesis at the cornea.
MéthodesA 46-year old man and a 36-year old woman presented with complaints of dry eyes and decrease in vision. Further anamnesis revealed nyctalopia. Medical history included Scopinaro surgery. Slit lamp examination showed corneal and conjunctival xerosis, with Bitot spots in one patient. Funduscopy showed a cotton wool in one patient and was normal in the other. VEP and visual fields were normal. Both scotopic and fotopic ERG indicated decreased retinal function. Laboratory investigation confirmed the suspected deficiency in vitamin A.
RésultatsTreatment with vitamin A enriched ointment and monthly intravenous vitamin A suppletion improved patient complaints.
ConclusionVitamin A deficiency is a rare diagnosis in developed countries. However, long term ophtalmic consequences of obesity surgery shouldn't be overlooked in differential diagnosis of xerophtalmia, decreased vision and nyctalopia.
Auteur 1
NomBARTHOLOMEEUSEN
InitialesE
InstitutUniversity Hospital Antwerp
VilleEdegem
Auteur 2
NomLeysen
InitialesI
InstitutUniversity Hospital Antwerp
VilleEdegem
Auteur 3
NomColebunders
InitialesB
InstitutUniversity Hospital Antwerp
VilleEdegem
Auteur 4
NomVan Looveren
InitialesJ
InstitutUniversity Hospital Antwerp
VilleEdegem
Auteur 5
NomTassignon
InitialesMJ
InstitutUniversity Hospital Antwerp
VilleEdegem
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