Akhunzada Muhammad Aftab, Fahimullah Khan, Hana Rehman, Farzana Muhammad Hassan, Mustafa Iqbal.
Vitamin B12 Levels in Patients investigated for Optic Atrophy without Ocular or Systemic Diseases.
Ophthalmol Update Jan ;13(4):250-3.

Purpose: To determine levels of vitamin B12 in patients investigated for optic atrophy without any ocular or systemic diseases. Methods: This retrospective review study was conducted in Khyber Teaching Hospital, Peshawar from April 2014 to April 2015. All patients with optic atrophy were investigated. Those who were diagnosed with ocular and (or) CNS or systemic co morbid conditions which would explain the optic atrophy were excluded from this study. Patients included in the study had serum vitamin B12 levels checked from a single laboratory. Automated Humphrey visual field analysis was carried out on all patients. Peripheral smear to exclude megaloblastic or pernicious anemia and neurological examination to exclude peripheral neuropathy was also carried out on all patients. Results: Total number of patients in our study were 20. There were 13 males (65%) while 7 (35%) females comprised our study group. Mean age of the patients was 41 years (18 years ? 52 years). Visual acuity ranged from 6/6 to hand movements using the Snellen visual acuity chart. Total number of patients with reduced Vitamin B12 levels were 16 (80%). Total number of males with reduced Vitamin B12 levels were 13 (81%) while 3 (19%) females had reduced levels. Mean Serum Vitamin B12 levels in these patients was 164.92 pg/ml (96- 206 pg/ ml). Regarding visual field defects, 10 (62%) patients had central or cecocentral defects while 4 (25%) patients presented with completely wiped out visual fields. Optic disc findings in 9 (56%) patients included temporal disc pallor, while 5 (31%) patients had optic atrophy. Peripheral smear revealed none of the patients had signs of megaloblastic anemia. 2 (12.5%) patients had signs of peripheral neuronal disease spectrum of vitamin B12 deficiency. Conclusion: Vitamin B12 deficiency may be an under looked cause of un-explained optic atrophy with central visual fields defects.

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