title: Nutritional optic neuropathy following bariatric surgery.
abstract: Bariatric procedures, associated with gastrointestinal malabsorption of vitamins and microelements, may constitute a risk factor for nutritional optic neuropathy (NON). We present a case of a 34-year-old female patient who developed bilateral NON after sleeve gastrectomy. Despite postoperative ophthalmological supervision, 10 months after the procedure the woman presented with a bilateral decrease in visual acuity down to 0.8, bilateral visual field loss and abnormal visual evoked potential recordings. Laboratory abnormalities included decreased serum concentration of vitamin B12 (161 pg/ml). Treatment was based on intramuscular injections of vitamin B12 (1000 units per day). After 1 week of the treatment, we observed more than a three-fold increase in the serum concentration of vitamin B12 and resolution of the bilateral symptoms of NON. The incidence of NON is likely to increase due to the growing number of these bariatric procedures performed worldwide. Therefore, all persons subjected to such surgery should receive long-term ophthalmological follow-up and supplementation with vitamins and microelements.
authors.affiliation: Department of Ophthalmology, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Sawicka-Pierko
authors.affiliation: Department of Ophthalmology, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Iwona
authors.initials: I
authors.lastname: Obuchowska
authors.affiliation: 1 Clinical Department of General and Endocrine Surgery, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Razak Hady
authors.initials: RH
authors.lastname: Hady
authors.affiliation: Department of Ophthalmology, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Zofia
authors.initials: Z
authors.lastname: Mariak
authors.affiliation: 1 Clinical Department of General and Endocrine Surgery, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Dadan
keywords: nutritional optic neuropathy; sleeve gastrectomy; vitamin B12 deficiency