Abstract：
OBJECTIVE: To report our findings of reduced full-field electroretinograms (ff-ERGs) and abnormal optical coherence tomographic (OCT) images in a patient with poor visual acuity after cataract surgery who was eventually diagnosed with vitamin A deficiency (VAD).
METHODS: This was a clinical study of a patient who complained of blurred vision after cataract surgery. To determine the cause of the reduced vision, we recorded full-field electroretinograms (ff-ERGs) to determine the scotopic and photopic status of the retina. We also performed optical coherence tomography to assess the changes in the retinal structure. Serological tests were performed.
RESULTS: A 74-year-old man presented with persistent corneal epithelial damages and reduced vision that developed after conventional cataract surgery. OCT showed an interrupted ellipsoid zone, and fundus autofluorescence (FAF) showed a severe hypofluorescence in the retina of the left eye. The scotopic ff-ERGs were severely reduced, and the photopic ff-ERGs were mildly reduced. Serological examinations revealed a vitamin A concentration < 7 IU/dL (normal, 97-316 IU/dL). Based on these findings, we diagnosed the patient with VAD and started treatment with oral vitamin A supplements. After three months, his visual acuity, ff-ERGs, and OCT findings recovered to normal levels. The amplitudes and implicit times of the RETeval flicker ERGs increased to be within the normal range, and the hypofluorescence of the left eye disappeared. The length of the photoreceptor outer segments increased after the vitamin A supplementation.
CONCLUSIONS: Our findings indicate that the ERGs are helpful for diagnosing patients with VAD associated with persistent corneal epithelial damages.
METHODS: This was a clinical study of a patient who complained of blurred vision after cataract surgery. To determine the cause of the reduced vision, we recorded full-field electroretinograms (ff-ERGs) to determine the scotopic and photopic status of the retina. We also performed optical coherence tomography to assess the changes in the retinal structure. Serological tests were performed.
RESULTS: A 74-year-old man presented with persistent corneal epithelial damages and reduced vision that developed after conventional cataract surgery. OCT showed an interrupted ellipsoid zone, and fundus autofluorescence (FAF) showed a severe hypofluorescence in the retina of the left eye. The scotopic ff-ERGs were severely reduced, and the photopic ff-ERGs were mildly reduced. Serological examinations revealed a vitamin A concentration < 7 IU/dL (normal, 97-316 IU/dL). Based on these findings, we diagnosed the patient with VAD and started treatment with oral vitamin A supplements. After three months, his visual acuity, ff-ERGs, and OCT findings recovered to normal levels. The amplitudes and implicit times of the RETeval flicker ERGs increased to be within the normal range, and the hypofluorescence of the left eye disappeared. The length of the photoreceptor outer segments increased after the vitamin A supplementation.
CONCLUSIONS: Our findings indicate that the ERGs are helpful for diagnosing patients with VAD associated with persistent corneal epithelial damages.
摘要：
目的：报告1例白内障手术后视力不佳、最终被诊断为维生素A缺乏症(VAD)的患者的全视网膜电图(ff-ERGs)和光学相干断层成像(OCT)异常的结果。
方法：这是一项对白内障手术后主诉视力模糊的患者的临床研究。为了确定视力下降的原因，我们记录了全视野视网膜电图(ff-ERGs),以确定视网膜的暗视和明视状态.我们还进行了光学相干断层扫描以评估视网膜结构的变化。进行血清学测试。
结果：一名74岁的男性患者表现为持续性角膜上皮损伤和在常规白内障手术后视力下降。OCT显示一个中断的椭球区，和眼底自发荧光（FAF）显示左眼视网膜中的严重低荧光。暗视的ff-ERG严重降低，明视ff-ERGs轻度降低。血清学检查显示维生素A浓度<7IU/dL（正常，97-316IU/dL)。基于这些发现,我们诊断患者患有VAD,并开始口服维生素A补充剂治疗.三个月后,他的视力,ff-ERGs,OCT检查结果恢复至正常水平。RETeval闪烁ERG的幅度和隐含时间增加到正常范围内，左眼的低荧光消失了.补充维生素A后，光感受器外节的长度增加。
结论：我们的研究结果表明，ERGs有助于诊断与持续性角膜上皮损伤相关的VAD患者。
方法：这是一项对白内障手术后主诉视力模糊的患者的临床研究。为了确定视力下降的原因，我们记录了全视野视网膜电图(ff-ERGs),以确定视网膜的暗视和明视状态.我们还进行了光学相干断层扫描以评估视网膜结构的变化。进行血清学测试。
结果：一名74岁的男性患者表现为持续性角膜上皮损伤和在常规白内障手术后视力下降。OCT显示一个中断的椭球区，和眼底自发荧光（FAF）显示左眼视网膜中的严重低荧光。暗视的ff-ERG严重降低，明视ff-ERGs轻度降低。血清学检查显示维生素A浓度<7IU/dL（正常，97-316IU/dL)。基于这些发现,我们诊断患者患有VAD,并开始口服维生素A补充剂治疗.三个月后,他的视力,ff-ERGs,OCT检查结果恢复至正常水平。RETeval闪烁ERG的幅度和隐含时间增加到正常范围内，左眼的低荧光消失了.补充维生素A后，光感受器外节的长度增加。
结论：我们的研究结果表明，ERGs有助于诊断与持续性角膜上皮损伤相关的VAD患者。
