Multimodal Imaging Study of Patients With Vitamin A Deficiency Retinopathy

OBJECTIVES: To describe multimodal imaging find-ings of vitamin A deficiency retinopathy. METHODS: A retrospective study of patients with serum retinol < 0.3 mg/L. Fundus color photos, spectral domain-optical coherence tomography (SD-OCT), and fundus autofluorescence (FAF) were reviewed and, when available, electrophysiological tests were analyzed.RESULTS: Forty-five eyes (63.9 & PLUSMN; 15.7 years) were included. Ultra-widefield fundus photography showed drusen-like deposits (53.3%) and macular retinal pigment epithelium (RPE) mottling (40%). The deposits were hypoautofluorescent, and a peri-foveal hyperautofluorescent ring was present in 8.9%. By SD-OCT, the ellipsoid zone had an irreg-ular appearance (100%) and conical deposits an-terior to the RPE (33.3%). Electroretinogram (ERG) (66.7%) showed a decrease in b-wave in the sco-topic registers, and microperimetry (4.4%) showed decreased foveal sensitivity. After vitamin A sup-plementation, SD-OCT and FAF showed resolution of all findings. Forty percent of eyes had restora-tion of the scotopic registers in ERG and improved macular sensitivity by microperimetry (4.4%).CONCLUSIONS: Vitamin A deficiency causes a mild cone dysfunction in addition to the more severe ab-sent rod response.