Jaggi, DamianDamianJaggiLincke, Joel-BenjaminJoel-BenjaminLinckeHeussen, Florian M.Florian M.HeussenUnterlauft, Jan D.Jan D.UnterlauftZinkernagel, Martin S.Martin S.Zinkernagel0000-0003-3447-2359Berger, Lieselotte E.Lieselotte E.Berger2025-06-262025-06-262025https://boris-portal.unibe.ch/handle/20.500.12422/212071Introduction Retinal alterations in vitamin A deficiency have been described. The purpose of this study was to report a case of retinal alterations and choroidal thickening due to proven vitamin A deficiency. Case Presentation We report a case of a 39-year-old woman who presented with progressing nyctalopia and mildly reduced visual acuity over a period of 1-2 years, despite being on oral vitamin A supplementation, following a history of gastric bypass and biliopancreatic diversion surgeries many years ago. Vitamin A levels were severely reduced (<0.1 µmol/L, reference range: 1.05-2.08 µmol/L). The outer retinal layers exhibited structural alterations and a reduction in thickness, while choroidal thickness was increased. The electroretinogram showed complete depletion of scotopic responses and a mild reduction in photopic responses. After intravenous vitamin A supplementation, complete resolution of both functional and structural changes was achieved. Conclusion This case highlights the importance of considering vitamin A deficiency even in patients receiving ongoing oral vitamin A supplementation, particularly if symptoms and clinical findings suggest its presence. Choroidal thickening and outer retinal thinning may provide further insights into the pathophysiology of this condition in future analyses.enCase reportChoroidMaculaOptical coherence tomographyRetinaVitamin A600 - Technology::610 - Medicine & healtharticle10.48620/887804050321610.1159/000544701