Vitamin A Deficiency

维生素 A 缺乏
  • 文章类型: Case Reports
    背景:Bartholin腺脓肿是育龄妇女最常见的感染之一。虽然Bartholin的腺脓肿在青春期前的儿童中已经有报道,青春期前儿童比成人更罕见。在这里,我们报告了1例维生素A缺乏的4岁女孩的双侧Bartholin腺脓肿。
    方法:一名被诊断为自闭症谱系障碍的4岁女孩因持续发烧和不适而入院接受密切检查和治疗。这个孩子是一个明显的挑食者,被诊断出患有角膜溃疡和继发于维生素A缺乏的夜盲症。病人的阴唇都肿了,使用计算机断层扫描诊断双侧Bartholin腺脓肿。切口引流在全身麻醉下进行。病人的术后过程是顺利的,手术后第8天她出院了.住院期间,尝试通过在饮食中添加营养补充剂来纠正维生素缺乏症。手术三个月后,未发现脓肿复发.
    结论:维生素A缺乏导致的免疫功能和粘膜屏障功能下降被认为是Bartholin腺脓肿的根本原因。虽然已经报道了青春期前Bartholin的腺脓肿,他们是罕见的。据我们所知,没有关于可能由维生素A缺乏引起的双侧Bartholin腺脓肿的报道。当青春期前女孩出现Bartholin\'s腺脓肿时,还应考虑由于维生素或微量元素缺乏引起的免疫缺陷。
    BACKGROUND: A Bartholin\'s gland abscess is one of the most common infections in women of reproductive age. Although Bartholin\'s gland abscesses have been reported in prepubertal children, they are rarer in prepubertal children than in adults. Herein, we report a case of bilateral Bartholin\'s gland abscesses in a 4-year-old girl with vitamin A deficiency.
    METHODS: A 4-year-old girl diagnosed with autism spectrum disorder was admitted to the hospital for close examination and treatment because of persistent fever and malaise. The child was a marked fussy eater and was diagnosed with corneal ulceration and night blindness secondary to vitamin A deficiency. Both of the patient\'s labia were swollen, and a diagnosis of a bilateral Bartholin\'s gland abscess was made using computed tomography. Incisional drainage was performed under general anesthesia. The patient\'s postoperative course was uneventful, and she was discharged from the hospital on day 8 after the surgery. During hospitalization, attempts were made to correct the vitamin deficiency by adding nutritional supplements to the diet. Three months after the surgery, no recurrence of abscesses was noted.
    CONCLUSIONS: Decreased immunocompetence and mucosal barrier function due to vitamin A deficiency is thought to be the underlying cause of Bartholin\'s gland abscesses. Although prepubertal Bartholin\'s gland abscesses have been reported, they are rare. To the best of our knowledge, no reports of bilateral Bartholin\'s gland abscesses potentially caused by vitamin A deficiency have been reported. When prepubertal girls present with Bartholin\'s gland abscesses, the presence of immunodeficiency due to vitamin or trace element deficiency should also be considered.
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  • 文章类型: Case Reports
    此病例介绍详细介绍了一名三岁男孩发烧的临床旅程,腹胀,和松散的大便。孩子的症状,对两家医院的初始治疗没有反应,导致发现肝酶升高,随后转诊至三级护理中心。临床检查显示肝肿大,腹胀,和不可触及的脾脏。实验室检查结果证实了急性肝炎,促使进一步调查儿童的饮食史,并揭示潜在的食源性感染。这个孩子被诊断患有肝炎相关的严重维生素A缺乏症,在眼科检查中表现为Bitot\的斑点。迅速开始抗病毒治疗,营养补充,支持性治疗导致了积极的临床反应,症状的解决和肝酶的正常化。这一案例强调了在传染病的背景下认识营养缺乏的重要性,强调需要全面的病人护理方法。这个复杂病例的成功管理凸显了跨学科合作在确保感染和营养病因重叠的儿科患者的最佳结果方面的重要性。
    This case presentation details the clinical journey of a three-year-old male child presenting with fever, abdominal distention, and loose stools. The child\'s symptoms, unresponsive to initial treatment at two hospitals, led to the discovery of elevated liver enzymes and subsequent referral to a tertiary care center. Clinical examination revealed hepatomegaly, abdominal distension, and non-palpable spleen. Laboratory findings confirmed acute hepatitis, prompting further investigation into the child\'s dietary history and revealing a potential foodborne infection. The child was diagnosed with hepatitis-associated severe vitamin A deficiency, manifested by Bitot\'s spots on ophthalmic examination. Prompt initiation of antiviral therapy, nutritional supplementation, and supportive care resulted in a positive clinical response, with resolution of symptoms and normalization of liver enzymes. This case underscores the importance of recognizing nutritional deficiencies in the context of infectious diseases, emphasizing the need for a comprehensive approach to patient care. The successful management of this complex case highlights the significance of interdisciplinary collaboration in ensuring optimal outcomes in pediatric patients with overlapping infectious and nutritional etiologies.
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  • 文章类型: Case Reports
    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。
    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.
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  • 文章类型: Journal Article
    根据最近的研究,反复呼吸道感染(RRTIs)在儿童中很常见,其发展可能与维生素A缺乏有关。这项研究的目的是了解儿童维生素A状态与RRTI之间的关系,以及膳食维生素A摄入量与RRTI的关系。
    来自中国黑龙江省的2,592名0.5-14岁儿童参加了调查。RRTI组由1,039名患有RRTI的儿童组成,将1,553名健康儿童纳入对照组。通过高效液相色谱法(HPLC)测定血清维生素A水平;通过食物频率问卷(FFQ)收集饮食信息。
    RRTI组血清维生素A浓度明显低于对照组(0.27±0.09mg/Lvs.0.29±0.09mg/L)(P<0.01)。维生素A水平与RRTI的发生明显相关。维生素A缺乏和缺乏的比值比(ORs)分别为1.32(95%CI:1.09-1.60)和1.95(95%CI:1.50-2.55);而分别为1.48(95%CI:1.13-1.94)和6.51(95%CI:4.18-10.14),当前有呼吸道感染(RTI)症状的儿童。即使动物肝脏摄入不足也与较低的RRTI相关[OR:0.45(95%CI:0.38-0.53)],而仅过量摄入肉类具有相同的效果[OR:0.85(95%CI:0.68-1.06)]。
    低血清维生素A浓度与中国东北地区儿童RRTI的高发病率相关;低血清维生素A浓度和当前的RTI症状与RRTI的发展相关;低摄入富含维生素A的食物也与RRTI的发展相关。
    UNASSIGNED: Recurrent respiratory tract infections (RRTIs) are common in children and its development might be associated with vitamin A deficiency according to recent research. The aim of this study was to understand the relation between vitamin A status and RRTIs in children, and the relation between dietary intake of vitamin A and RRTIs.
    UNASSIGNED: 2,592 children aged 0.5-14 years from Heilongjiang province of China participated in the survey. The RRTI group consisted of 1,039 children with RRTIs, while 1,553 healthy children were included in the control group. The levels of serum vitamin A were determined by high performance liquid chromatography (HPLC); dietary information was collected with the Food Frequency Questionnaire (FFQ).
    UNASSIGNED: Serum vitamin A concentration in the RRTI group was significantly lower than that in the control group (0.27 ± 0.09 mg/L vs. 0.29 ± 0.09 mg/L) (P < 0.01). The levels of vitamin A was obviously associated with the occurrence of RRTIs. The odds ratios (ORs) for vitamin A insufficiency and deficiency were 1.32 (95% CI: 1.09-1.60) and 1.95 (95% CI: 1.50-2.55) respectively; whereas 1.48 (95% CI: 1.13-1.94) and 6.51 (95% CI: 4.18-10.14) respectively, in children with current respiratory tract infection (RTI) symptoms. Even an insufficient intake of animal liver was associated with lower RRTIs [OR: 0.45 (95% CI: 0.38-0.53)], while only an excessive intake of meat had the same effect [OR: 0.85 (95% CI: 0.68-1.06)].
    UNASSIGNED: Low serum vitamin A concentration was associated with high incidence of RRTIs in children in northeast China; low serum vitamin A concentrations and the current RTI symptoms were associated with the development of RRTIs; and low intakes of vitamin A-rich foods were also associated with the development of RRTIs.
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  • 文章类型: Journal Article
    目的:维生素A缺乏视网膜病是一种潜在的致盲疾病。在发达国家,由于营养不良导致的维生素A缺乏是罕见的。然而,维生素A缺乏可由肠道切除或药物治疗引起的吸收不良引起。在这项回顾性研究中,我们介绍了5例维生素A缺乏症视网膜病变与继发于医学干预的吸收不良有关。
    方法:对10年(2012-2022年)的电子图表进行维生素A缺乏视网膜病变筛查。仅包括经实验室检查证实的维生素A缺乏患者。症状,病史,视敏度,光学相干层析成像,眼底自发荧光,电生理检查,并对维生素A水平进行了综述。
    结果:确定了5例合格病例。中位年龄为44.7岁(范围22.2-88.9),诊断前眼部症状的中位持续时间为14个月,中位视力为1.0(范围为0.5-1.0,Snellen,decimal)。三名患者有减肥手术史,一名患者接受了小肠切除术,正在接受奥曲肽治疗,1例患者患有囊性纤维化,有小肠切除和严重肝病史。光学相干断层扫描显示各种异常,包括减少的交叉区域,视网膜下树状软骨沉积,和外部核层变薄。视网膜电图发现范围从异常振荡电位到不可记录的杆状反应。
    结论:维生素A缺乏视网膜病变可发生在与吸收不良相关的医学干预之后。在夜盲症的情况下,应该测量维生素A水平。
    Vitamin A deficiency retinopathy is a potentially blinding disease. In developed countries, vitamin A deficiency due to malnutrition is rare. However, vitamin A deficiency can be caused by malabsorption resulting from bowel resection or medication. In this retrospective study, we present five cases of vitamin A deficiency retinopathy related to malabsorption secondary to medical interventions.
    Electronic charts over a ten-year period (2012-2022) were screened for vitamin A deficiency retinopathy. Only patients with vitamin A deficiency confirmed by laboratory tests were included. Symptoms, medical history, visual acuity, optical coherence tomography, fundus autofluorescence, electrophysiological examination, and vitamin A levels were reviewed.
    Five eligible cases were identified. Median age was 44.7 years (range 22.2-88.9), median duration of ocular symptoms prior to diagnosis was 14 months, and median visual acuity was 1.0 (range 0.5-1.0, Snellen, decimal). Three patients had a history of bariatric surgery, one patient had a small bowel resection and was on octreotide treatment, and one patient suffered from cystic fibrosis and had a history of small bowel resection and severe hepatopathy. Optical coherence tomography showed various abnormalities, including a reduced interdigitation zone, subretinal drusenoid deposits, and a thinned outer nuclear layer. Electroretinogram findings ranged from abnormal oscillatory potentials to non-recordable rod responses.
    Vitamin A deficiency retinopathy can occur following medical interventions associated with malabsorption. In cases of night blindness, vitamin A levels should be measured.
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  • 文章类型: Journal Article
    视网膜色素变性(RP)显示广泛的表型变异,经常与获得性视网膜疾病重叠。由于许多此类条件的可治疗性,因此及时识别和区分RP伪装至关重要。这篇综述旨在介绍伪RP案例的例子,并提供RP伪装的全面概述。我们首先提出两个伪RP案例,包括全面的临床病史和多模态视网膜成像,强调准确诊断的重要作用,随后引导有效的干预措施。随后,我们对RP化装舞会进行了深入审查,以提供对其主要区别特征和管理考虑因素的宝贵见解。最近批准的眼部基因疗法和研究性基因为基础的治疗的发展带来了基因检测为RP患者的前沿。然而,值得注意的是,基因检测目前缺乏作为遗传性视网膜疾病(IRD)筛查工具的实用性,包括RP。准确的临床评估的完整性对于RP和RP伪装条件的诊断仍然是必不可少的。从而促进及时干预和适当的管理策略。
    Retinitis pigmentosa (RP) displays a broad range of phenotypic variations, often overlapping with acquired retinal diseases. Timely recognition and differentiation of RP masquerades is paramount due to the treatable nature of many such conditions. This review seeks to present examples of pseudo-RP cases and provide a comprehensive overview of RP masquerades. We first present two pseudo-RP cases, including comprehensive clinical histories and multimodal retinal imaging, to highlight the important role of accurate diagnoses that subsequently steered effective intervention. Subsequently, we conduct an in-depth review of RP masquerades to provide valuable insights into their key distinguishing features and management considerations. The recent approval of ocular gene therapy and the development of investigational gene-based treatments have brought genetic testing to the forefront for RP patients. However, it is important to note that genetic testing currently lacks utility as a screening tool for inherited retinal diseases (IRDs), including RP. The integrity of a precise clinical assessment remains indispensable for the diagnosis of both RP and RP masquerade conditions, thereby facilitating prompt intervention and appropriate management strategies.
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  • 文章类型: Case Reports
    我们报告了一例自闭症谱系障碍(ASD)和继发于维生素A缺乏症的穿孔性角膜软化症患者。一个6岁的男孩抱怨眼睑难以张开。眼结膜充血并角化,化脓性眼(眼)分泌物。两个角膜均显示上皮缺损,并伴有出囊不足。血清维生素A水平≤5IU/dL(正常值97-316),导致因维生素A缺乏而诊断为干眼症和角膜软化症。肌内注射维生素A(50,000IU/天),以及口服多种维生素(含有2,500IU的维生素A)和锌补充剂50毫克/天,允许他在诊断后14天睁开眼睛并对平板设备表现出兴趣。在治疗过程中,观察到角膜穿孔,但在没有佩戴隐形眼镜或羊膜贴剂的情况下将其关闭,并使用维生素A替代疗法和抗菌滴眼液进行管理。上皮延伸到已经融化的右角膜区域,尽管留下了角膜混浊的疤痕,没有明显的感染迹象。早期诊断很困难,因为患有ASD的儿童不会表达抱怨,对于饮食严重不均衡且难以张开眼睑的患者,应考虑维生素A缺乏症。
    We report a case of a patient with autism spectrum disorder (ASD) and perforated keratomalacia secondary to vitamin A deficiency. A 6-year-old boy complained of difficulty in opening the eyelids. The ocular conjunctiva was hyperemic and keratinized with purulent ocular (eye) discharge. Both corneas showed epithelial defects with hypopyon. The serum vitamin A level was ≤5 IU/dL (normal 97-316), leading to a diagnosis of xerophthalmia and keratomalacia due to vitamin A deficiency. Intramuscular injection of vitamin A (50,000 IU/day), as well as oral administration of multivitamin (containing 2,500 IU of vitamin A) and zinc supplement at 50 mg/day, allowed him to open both eyes and show interest in tablet devices 14 days after the diagnosis. During the course of the treatment, corneal perforation was observed, but it was closed without contact lens wear or amniotic patch and managed with vitamin A replacement therapy and antimicrobial eye drops. The epithelium extended to the area of the right cornea that had been melted, and although scarring corneal opacity remained, there were no obvious signs of infection. Early diagnosis is difficult because children with ASD do not express complaints, and vitamin A deficiency should be considered in patients with a severely unbalanced diet and complaints of difficulty opening the eyelids.
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  • 文章类型: Journal Article
    背景:橙皮甘薯(OFSP)通过育种用维生素A前体进行生物强化,因此非常适合对抗维生素A缺乏症(VAD)。促进OFSP消费的潜在机制之一是通过加工成具有更长保质期和消费者更期望的产品来提高其可用性。然而,由于市场不确定性,很少有农民和农产品加工商实行增值;关于OFSP产品的市场可得性的信息很少。这项研究调查了肯尼亚农村和城市地区消费者对OFSP果泥chapati的偏好,使用或有估值法。从411名甘薯消费者的随机样本中收集数据,并应用双边界logit模型分析了消费者对OFSP果泥chapati的支付意愿(WTP)。
    结果:消费者愿意为霍马湾和内罗毕县的OFSP纯泥chapati支付19克什(0.14美元)和35克什(0.26美元)的价格,分别。一个家庭里有五岁以下的孩子,消费者对OFSP产品的认识和消费OFSP的好处,教育水平对两个地区OFSP果泥薄饼的WTP有积极而显着的影响。
    结论:研究表明,消费者对OFSP果泥chapati表现出积极的偏好。为了增加OFSP及其增值产品的消费量,重要的是,通过烹饪演示和其他轻推方法,提高消费者对OFSP果泥chapati和其他此类营养产品的认识,使用有吸引力的插图和社交媒体平台,吸引五岁以下儿童以及青年的母亲和护理人员。本文受版权保护。保留所有权利。
    BACKGROUND: Orange-fleshed sweet potato (OFSP) is bio-fortified with vitamin A precursors through breeding and is thus ideal for combating vitamin A deficiency (VAD). One of the potential mechanisms to promote the consumption of OFSP is to enhance its availability through processing into products with a longer shelf life and more desirable to consumers. However, very few farmers and agro-processors practice value addition due to market uncertainties; there is little information on market availability for OFSP products. This study examined consumers\' preference for OFSP puree chapati in rural and urban areas of Kenya, using the contingent valuation method. Data was collected from a random sample of 411 sweet potato consumers and a double-bounded logit model was applied to analyze consumers\' willingness to pay (WTP) for OFSP puree chapati.
    RESULTS: Consumers were willing to pay a price of Kenya shillings (KES) 19 (USD 0.14) and 35 (USD 0.26) for OFSP puree chapati in Homa Bay and Nairobi counties, respectively. The presence of children under 5 years in a household, consumers\' awareness of OFSP products and benefits of consuming OFSP, and level of education had a positive and significant influence on WTP for OFSP puree chapati in both regions.
    CONCLUSIONS: The study demonstrated that consumers exhibited a positive preference for OFSP puree chapati. In order to increase the consumption of OFSP and its value-added products, it is important to promote consumer awareness of OFSP puree chapati and other such nutritious products through cooking demonstrations and other nudging approaches using attractive illustrations and social media platforms that engage mothers and care-givers of children under 5 years old as well as the youth. © 2023 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.
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  • 文章类型: Case Reports
    Vitamin A is a micronutrient critical for retinal function. Patients with a deficiency may notice a progressive decline in night vision as rod photoreceptors become unable to regenerate rhodopsin. Although uncommon in developed nations, vitamin A deficiency should be considered in symptomatic patients with chronic, severe liver disease.
    This report presents a rare case of night blindness secondary to poor vitamin A metabolism due to severe liver cirrhosis.
    A 62-year-old White woman presented with progressively worsening vision in dim lighting over the past 6 to 8 months. She was asymptomatic in daylight but \"blind in the dark\" to the extent that she was afraid to go outside at night. She had no personal or family history of night blindness or retinal disorders. Ocular health was unremarkable with dilation. Given her medical history of severe nonalcoholic liver cirrhosis, malabsorption of vitamin A was suspected and subsequently confirmed by the very low vitamin A level in her serum analysis. The patient was sent to endocrinology for evaluation, and appropriate repletion therapy was implemented. Subjective improvement in symptoms, along with better performance on visual field testing, was noted after initiating oral vitamin A supplementation for 5 months.
    Although vitamin A deficiency is a relatively rare disorder in the United States, it should be suspected in patients with severe liver disease or other conditions causing malabsorption who experience a loss of night vision.
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  • 文章类型: Case Reports
    目的:报告意外的不对称,1例长期限制饮食史的15岁女性进行性营养性视神经病变与维生素A缺乏视神经管骨增生相关。
    方法:我们对一名15岁女性进行了全面的眼科评估,该女性长期限制进食,怀疑有营养性视神经病变,主要影响右眼视力。
    结果:对计算机断层扫描和磁共振成像的回顾显示双侧视神经管增生可能与维生素A缺乏有关。电诊断测试和光学相干断层扫描提供了双侧视网膜神经节细胞功能障碍的结构功能证据,并且显着显示左眼颞叶纤维严重丢失,显示头颅中央暗点,但视力正常。尽管乳头状瘤束的选择性损伤在营养性和毒性视神经病变中已得到充分证明,营养缺乏继发的压迫性视神经管骨肥大的报道很少。
    结论:高收入国家的营养缺乏正在增加,可能与胃肠道疾病的增加有关,严格的素食和素食饮食以及与抑郁症和自闭症谱系综合征(ASD)等相关的避免限制性食物摄入障碍(ARFID)。我们的发现突出了电诊断测试与成像在复杂的营养性视神经病变中的价值,以帮助监测,指导治疗并保持儿童的剩余视力。
    To report an unexpectedly asymmetric, progressive nutritional optic neuropathy associated with vitamin A deficient optic canal hyperostosis in a 15-year-old female with a long history of a restricted diet.
    We performed comprehensive ophthalmic assessments in a fifteen-year-old female with a long history of restricted eating who presented with suspected nutritional optic neuropathy, predominantly affecting the right eye vision.
    A review of computerised tomography and magnetic resonance imaging revealed bilateral optic canal hyperostosis likely associated with vitamin A deficiency. Electrodiagnostic tests and optical coherence tomography provided structure-function evidence of bilateral retinal ganglion cell dysfunction and notably revealed severe loss of temporal fibres in the left eye which showed cecocentral scotoma but normal visual acuity. Although selective damage of the papillomacular bundle has been well-documented in nutritional and toxic optic neuropathies, compressive optic canal hyperostosis secondary to nutritional deficiency has been rarely reported.
    Nutritional deficiencies are increasing in high-income countries and may be linked to the rise of gastrointestinal disorders, strict vegan and vegetarian diets and avoidant restrictive food intake disorder (ARFID) associated with conditions such as depression and autism spectrum syndrome (ASD). Our findings highlight the value of electrodiagnostic testing alongside imaging in complex nutritional optic neuropathies to help monitor, guide treatment and preserve remaining sight in a child.
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