Optic Neuropathy from Vitamin B12 Deficiency Associated With Alcoholism and Malnutrition

ABSTRACT

PURPOSE: To report a case of optic neuropathy from vitamin B12 deficiency associated with chronic alcoholism and malnutrition. CASE SUMMARY: A 51-year-old man with a complaint of declining visual acuity in both eyes without pain was found to have a temporal optic disc pallor in the left eye. The patient had a history of chronic alcoholism and malnutrition for the previous 7 months. Visual field examination showed central scotoma in both eyes. The vitamin B12 level was undetectable by a blood biochemistry test. Blood dyscrasia such as anemia or thrombocytopenia was not found. The vitamin B12 level became normal after intramuscular cobalamin injections, and visual acuity and visual field tests recovered after 3 months. CONCLUSIONS: Optic neuropathy from vitamin B12 deficiency can be solely present without other systemic manifestations in a patient with chronic alcoholism and malnutrition. Prompt diagnosis by thorough history taking and vitamin B12 supplementation can reverse the disease.