Macular thickness analysis and resolution of subretinal drusenoid deposits with optical coherence tomography in vitamin A deficiency-related retinopathy

PURPOSE: To report the resolution of subretinal drusenoid deposits (SDDs) and the changes in macular thickness at various segmentation levels in a patient who was treated for vitamin A deficiency-related retinopathy. OBSERVATIONS: A 67-year-old man with cirrhosis secondary to hepatitis C was referred for unexplained vision decline and nyctalopia. He was diagnosed with vitamin A deficiency after he was found to have yellow-white drusen-like deposits in the posterior pole and midperiphery, which corresponded to SDDs on optical coherence tomography (OCT). Treatment with vitamin A supplementation was initiated, and, over the course of eight months, the symptoms improved, the SDDs resolved, and retinal thickness generally increased, although the rate and pattern of change differed depending on the macular quadrant and the segmentation layer being analyzed. CONCLUSIONS AND IMPORTANCE: Vitamin A deficiency should be considered in patients with liver disease who present with drusen-like deposits in the macula and midperiphery. Prompt recognition and treatment may improve symptoms and reverse some retinal pathology, including the presence of SDDs. Vitamin A supplementation in these patients seems to affect the inner retina and outer retina differently.