{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T11:27:02Z","timestamp":1792063622973,"version":"4.4.0"},"reference-count":57,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T00:00:00Z","timestamp":1777420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Ophthalmol."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To characterize clinical features, risk factors, and outcomes of vitamin A deficiency (VAD) among patients with gastrointestinal (GI) and\/or hepatobiliary comorbidities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study examined patients with GI or hepatobiliary disease who presented with ocular manifestations of VAD. Extracted data included patient demographics, underlying GI or hepatobiliary diagnoses, serum vitamin A levels, ophthalmic symptoms and examination findings, imaging features, and response to vitamin A repletion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>26 eyes from 13 patients were included. The most common systemic comorbidities were fatty liver disease (38.5%), prior gastric bypass surgery (23.1%), and cirrhosis (23.1%). Median serum vitamin A level at diagnosis was 19.1 mcg\/dL (range, 2.5\u201336.1 mcg\/dL, reference range 38\u201372 mcg\/dL). Median presenting best visual corrected acuity (BCVA) was 20\/50 (logmar 0.44, range, 20\/20-light perception). Twenty-two eyes (84.6%) demonstrated anterior segment manifestations of VAD, including four eyes (15.4%) who presented with bilateral corneal ulceration and perforation. Posterior segment findings were present in 16 eyes (61.5%), including subretinal drusenoid deposits, RPE mottling, placoid macular changes, optic neuropathy, and a full-thickness macular hole. All patients reported bilateral vision loss, with 63.6% endorsing nyctalopia. All patients who underwent vitamin A repletion experienced subjective visual improvement and partial or complete resolution of ophthalmic findings, including regression of anterior and posterior segment pathology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Vitamin A deficiency occurs across a wide spectrum of GI and hepatobiliary diseases and is associated with diverse anterior and posterior segment ocular findings, ranging from subtle surface disease to severe, vision-threatening pathology. Visual symptoms and ocular findings improved following vitamin A repletion, highlighting the preventable and reversible nature of this condition when identified early. Given the risk of irreversible ocular sequelae with delayed diagnosis, serum vitamin A assessment with timely repletion should be considered in patients with at-risk gastrointestinal and hepatobiliary conditions. Early identification through multidisciplinary care may prevent avoidable, vision-threatening ocular complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fopht.2026.1779060","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T04:38:56Z","timestamp":1777437536000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Ocular manifestations of vitamin A deficiency in gastrointestinal and hepatobiliary disease"],"prefix":"10.3389","volume":"6","author":[{"given":"Eric W.","family":"Lai","sequence":"first","affiliation":[{"name":"Department of Ophthalmology and Visual Science, Yale School of Medicine","place":["New Haven, CT, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Walter Reed National Military Medical Center","place":["Bethesda, MD, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Chen","sequence":"additional","affiliation":[{"name":"Section of Digestive Diseases, Department of Internal Medicine, Yale School of Medicine","place":["New Haven, CT, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih-Chung","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Shuang-Ho Hospital, Taipei Medical University","place":["New Taipei City, Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Visual Science, Yale School of Medicine","place":["New Haven, CT, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sidney A.","family":"Schechet","sequence":"additional","affiliation":[{"name":"Elman Retina Group","place":["Baltimore, MD, United 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