J Korean Ophthalmol Soc.  2009 Jun;50(6):963-967. 10.3341/jkos.2009.50.6.963.

Optic Neuropathy from Vitamin B12 Deficiency Associated With Alcoholism and Malnutrition

• Lee JR
• Kim YD
• Choi JY
• Choi J

• KMID: 2212379
• DOI: http://doi.org/10.3341/jkos.2009.50.6.963

Abstract

PURPOSE: To report a case of optic neuropathy from vitamin B12 deficiency associated with chronic alcoholism and malnutrition.
CASE SUMMARY
A 51-year-old man with a complaint of declining visual acuity in both eyes without pain was found to have a temporal optic disc pallor in the left eye. The patient had a history of chronic alcoholism and malnutrition for the previous 7 months. Visual field examination showed central scotoma in both eyes. The vitamin B12 level was undetectable by a blood biochemistry test. Blood dyscrasia such as anemia or thrombocytopenia was not found. The vitamin B12 level became normal after intramuscular cobalamin injections, and visual acuity and visual field tests recovered after 3 months.
CONCLUSIONS
Optic neuropathy from vitamin B12 deficiency can be solely present without other systemic manifestations in a patient with chronic alcoholism and malnutrition. Prompt diagnosis by thorough history taking and vitamin B12 supplementation can reverse the disease.

Keyword

Alcoholism; Malnutrition; Optic neuropathy; Vitamin B12 deficiency

MeSH Terms

Alcoholism
Anemia
Biochemistry
Eye
Humans
Malnutrition
Middle Aged
Optic Nerve Diseases
Pallor
Scotoma
Thrombocytopenia
Visual Acuity
Visual Field Tests
Visual Fields
Vitamin B 12
Vitamin B 12 Deficiency
Vitamins
Vitamin B 12
Vitamins

Figure

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  Figure 1. Humphrey visual field examination at initial presentation reveals central scotoma in both eyes. Mean deviation and pattern standard deviation values were worse in the left eye (B) than in the right eye (A).

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  Figure 2. Optic disc photographs at initial presentation. (A) Right eye, (B) Mild temporal pallor is present in the left eye.

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  Figure 3. Humphrey visual field examination 3 months after vitamin B12 supplement reveals no scotoma in both eyes (A: right eye, B: left eye).

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  Figure 4. Optic disc photographs 3 months after vitamin B12 supplement. There seems to be no difference in the optic disc color between eyes (A: right eye, B: left eye).

Reference

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