Reduced macular pigment in vitamin A deficiency retinopathy

Vitamin A deficiency (VAD) can lead to rod then cone dysfunction. We evaluated fundus autofluorescence (FAF) and optical coherence tomography (OCT) images in patients with confirmed VAD. Five patients (10 eyes) were included, with VAD related to Crohn's disease (n=4) and deficiency of fat soluble vitamins of unknown cause (n=1). After vitamin A supplementation, mean visual acuity improved from 0.2 to 0.1 logMAR, and the initially observed ellipsoid and interdigitation zone abnormalities on OCT imaging improved, supporting previous reports. In contrast, we describe a lack of normal foveal hypoautofluorescence on FAF imaging, which persisted post-treatment and could also be a useful diagnostic sign.