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The effects of vitamin B12 deficiency on retina and optic disk vascular density

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Abstract

Purpose

In this study, we aimed to determine the alterations in the retina and peripapillary vascular density in patients with vitamin B12 deficiency.

Material and method

The patients were divided into two groups regarding their vitamin B12 levels as the low vitamin B12 group (< 200 pg/ml) and the normal vitamin B12 group (≥ 200 pg/ml). The retinal nerve fiber layer thickness (RNFLT) and the central macular thickness (CMT) were measured through an SD-OCT analysis. The foveal avascular zone (FAZ), vessel density (VD) of the superficial capillary plexus (SCP), and deep capillary plexus (DCP) of the macula, and the VD of the radial peripapillary capillary plexus (RPCP) for the optic disk were determined by OCT-A.

Results

Thirty-three patients were in the low vitamin B12 group and 54 were in the normal group. The mean RNFLT measurements were significantly lower in the low vitamin B12 group (p = 0.001). The RPCP values in all quadrants were significantly lower in the patients with vitamin B12 deficiency (p = 0.001); moreover, there was a significant increase in the FAZ value with a decrease in both superficial (p = 0.001) and deep (p = 0.001) VDs. There was a significant positive correlation between the serum vitamin B12 levels and the RPCP values and superficial and deep VDs, while the FAZ value was negatively correlated with the vitamin B12 levels.

Conclusion

Vitamin B12 deficiency has diverse effects on ocular structures and retinal vasculature. Decreased VDs and increased FAZ may be associated with severe ocular alterations in the long term, which should be further investigated.

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Data availability

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Funding

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Authors and Affiliations

  1. Department of Ophthalmology, Faculty of Medicine, Erzincan Binali Yıldırım University, Erzincan, Turkey

    Erel Icel

  2. Department of Ophthalmology, University of Health Sciences Turkey, Sisli Hamidiye Etfal Training and Research Hospital, İstanbul, Turkey

    Turgay Ucak

Authors
  1. Erel Icel
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  2. Turgay Ucak
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Contributions

IE planned the study, UT and IE contributed to the literature search and data extraction together, UT drafted and submitted the manuscript.

Corresponding author

Correspondence to Turgay Ucak.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Patients signed informed consent regarding publishing their data and photographs.

Ethical approval

This cross-sectional study was conducted between November 2019 and March 2020 after receiving approval from the ethics committee of Erzincan University (33216249–604.01.02–E.48489 11/10/2019). All procedures performed in studies involving human participants were following the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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All patients provided written informed consent.

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Icel, E., Ucak, T. The effects of vitamin B12 deficiency on retina and optic disk vascular density. Int Ophthalmol 41, 3145–3151 (2021). https://doi.org/10.1007/s10792-021-01879-x

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  • DOI: https://doi.org/10.1007/s10792-021-01879-x

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