Vitamin a Deficiency in an Elderly Patient: A Diagnostic Challenge in the Age of AMD

Jakob M Pericak,1,2 Eric K Chin,3,4 David RP Almeida2 1State University of New York at Geneseo, Geneseo, NY, USA; 2Erie Retina Research & Center for Advanced Surgical Exploration, Erie, PA, USA; 3Retina Consultants of Southern California, Redlands, CA, USA; 4Loma Linda Eye Institute; Veterans Affair Hospital, Loma Linda, CA, USACorrespondence: David RP Almeida, Erie Retina Research & Center for Advanced Surgical Exploration, 300 State Street, Suite 302, Erie, PA, 16507, USA, Tel +1 814 476 6227, Fax +1 888 422 5096, Email [email protected]: The presentation of vitamin A deficiency (VAD)-induced ocular complications can be challenging to diagnose in elderly patients, particularly due to the overlap with age-related macular degeneration (AMD) symptoms. This case report details the presentation, diagnosis, and management of an 88-year-old female with vision loss, highlighting the ocular manifestations of presumed VAD. Despite vitamin A levels being at the lower end of the normal range, the patient’s symptoms and spectral domain optical coherence tomography (SD-OCT) findings suggested insufficient levels, leading to thinning of the outer nuclear layer. This case underscores the necessity of considering VAD in differential diagnoses of unexplained vision impairment, particularly in individuals with a history of intestinal malabsorption, while also emphasizing the importance of distinguishing VAD from AMD in elderly patients.Keywords: vitamin A deficiency, malabsorption syndrome, age-related macular degeneration