Folic acid deficiency optic neuropathy: A case report.

 

This case highlights an unusual presentation of folic acid deficiency that may present to the general physician.

Folate deficient optic neuropathy is uncommon and early recognition and treatment are important to prevent persistent visual defects. It is usually associated with starvation, malabsorption or excessive alcohol consumption. Dimness of vision is the outstanding symptom and it may initially be unilateral. It is a painless neuropathy. Alternative presenting symptoms are general loss of colour perception and dyschromatopsia. Other aspects of folate deficiency are axonal neuropathy, anaemia and encephalopathy.

A 44-year-old woman presented with a 4-week history of progressive visual loss and was noted to have bilateral retrobulbar optic neuropathy. No other clinical abnormality was noted. Investigations revealed severe folate deficiency with normal vitamin B12 levels. Her alcohol and tobacco consumption was moderate and subsequent correction of folate levels with oral supplementation has led to improvement in her visual acuity.

Folic acid deficient optic neuropathy has a good prognosis if treatment is initiated in the first few months after the onset of symptoms. It has been noted that visual acuity tends to recover before colour vision and when recovery is complete, recurrences are unusual.

In conclusion, in this case folate deficiency presented as visual abnormalities, and showed it is possible to have folate deficient optic neuropathy with no other clinical manifestation of folate deficient anaemia, and that folate deficiency can occur in the absence of excessive alcohol and tobacco consumption. This case is an unusual manifestation of nutritional deficiency which may present to the general physician, but when recognized promptly, can be corrected with vitamin supplementation.

 

(SOURCE) Journal of Medical Case Reports 2008, 2:299.

 

A good source of Folate and other vision-protective nutrients is MDR Vision Formula.