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Category: Volume 06 Issue 07 July 2018
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Title: RNFL defect with vitamin B12 deficiency correlating diet pattern: Experience in tertiary care hospital

Authors: Swati Samant, Srikant Kumar Dhar, Priyanka Samal, Suchismita Mishra, Ankita Choudhury, Nikita Jaiswal, Mahesh Chandra Sahu

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i7.177

Abstract

Purpose: Comparision of peri-papillary nerve fibre layer (RNLF)  thickness of patients with vitamin B12 deficiency with that of healthy controls measured by 3D spectral domain Optical Coherence Tomography (OCT) and to evaluate the correlation between peri-papillary RNFL thickness and plasma vitamin B12 levels and their association with vegetarian diet pattern.

Material and Methods: 25 patients with a diagnosis of vitamin B12 deficiency and 25 age and sex matched controls were included in this prospective study. Blood count, vitamin B12 level, folate level, and other biochemical parameters were obtained for all the cases and controls. Temporal, nasal, inferior and superior peripapillary RNFL thickness were obtained using 3D spectral domain OCT. Disc area, rim area and cube volume were also measured.

Result: Mean age of the patient and control group was 34.40 ± 10.90 and 34.36 ± 9.38 respectively. Mean plasma vitamin B12 level was 160.84 ± 40.65 in the group and 471.32 ± 86.88 in the control group. (p< 0.001). There was no significant difference between the two groups concerning disc area (DA), rim area (RA), cup volume (CV) and RNFL thickness in superior, inferior and nasal quadrants. However RNFL in temporal quadrant was significantly thinner in the patient group than in the control group (p<0.001). Temporal RNFL thickness had a strong correlation with vitamin B12 levels.). (0.004). It was further noted that the vitamin B12 deficiency was significantly related to the vegetarian population.           

Conclusion: Our study showed that temporal quadrant RNFL thickness was thinner in patients with vitamin B12 deficiency and it was correlated with the plasma vitamin B12 levels. Moreover it was found more in persons with vegetarian diet pattern.

Keywords: RNFL, OCT, vitamin B12, diet.

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Corresponding Author

Dr Srikant Kumar Dhar

Associate Professor, Dept of Medicine, IMS and SUM hospital, Siksha “O” Anusandhan Deemed to be University

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