Retinal changes associated with multivitamin deficiency before and after supplementation

Background Nutritional visual defects are apparently uncommon nowadays in developed nations. Retinal change-related caused by hypovitaminoses may be underdiagnosed. Aim of the study To investigate retinal structural and functional changes a patient with multivitamin deficiency before during vitamin supplementation. Methods A 51-year-old female had been on vegetarian diet as child, restrict vegan last 2 years, developing severe bilateral deterioration function polyneuropathy. Blood test revealed low levels A, B6 D. The underwent examinations optical coherence tomography (OCT), computerized field examination (VF), electroretinography (ERG), evoked potentials (VEP) neurography after Results Visual acuity (VA) was 20/1000 VF showed central scotoma both eyes. Color vision significantly affected. Full-field ERG normal rod cone function, but clearly reduced peak registered multifocal (mf-ERG), indicating impaired fovea function. VEP delayed latency amplitude P100 Neurography sensory OCT significant thinning macular ganglion cell plus inner plexiform layer (GCIPL) rapid progression. nerve fiber (RNFL) preserved normal, which is contrast to neuroinflammatory conditions. After 2.5 years supplementation, functions were improved. GCIPL thickness stable without further deterioration. Conclusions Multivitamin results progressive In neuroinflammation, RNFL normal. Stabilized supplementation associated improved provides sensitive objective measure for differential diagnosis, monitoring change response therapy.