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You are what you eat: ophthalmological manifestations of severe B12 deficiency
  1. Cátia Azenha1,2,
  2. José F Costa1,
  3. Pedro Fonseca1,2
  1. 1Department of Ophthalmology, Centro Hospitalar Universitario de Coimbra, Coimbra, Portugal
  2. 2Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal
  1. Correspondence to Dr Cátia Azenha, c.azenha{at}


Severe B12 vitamin deficiency due to diminished dietary intake is a known cause of severe pancytopenia with bleeding diathesis. The authors report a case with sudden-onset bilateral vision loss, severe pancytopenia and multiple organ failure secondary to B12 vitamin deficiency in a patient with a strict vegetarian diet. On funduscopic examination the patient had multiple bilateral exuberant haemorrhages in all retinal layers. Five months after presentation, he had a complete visual recovery without ophthalmological intervention.

  • Retina
  • Ophthalmology
  • Haematology (incl blood transfusion)
  • Malnutrition
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  • Contributors CA: conception and design of the work, data collection, data analysis and interpretation, drafting of the article, critical revision of the article.

    JFC: data collection, critical revision of the article.

    PF: data analysis and interpretation, critical revision of the article.

    All authors review and approved the final version of the manuscript to be published.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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