Nutritional Optic Neuropathy From Chronic Omeprazole Use.

Abstract

N utritional optic neuropathy is a condition characterized by progressive, painless, symmetrical loss of vision, in the form central or cecocentral scotomas, due to a deficiency in certain essential nutrients. It can also present with dyschromatopsia, decreased contrast sensitivity, and temporal optic disc pallor. In recent years, it has been classified under the umbrella of mitochondrial optic neuropathies, which include both inherited (Leber’s hereditary optic neuropathy and dominant optic atrophy) and acquired (nutritional and toxic optic neuropathies). Regardless of the underlying etiology, studies have shown that nutritional neuropathies share a selective damage and loss of retinal ganglion cells due to mitochondrial dysfunction in the prelaminar area of the optic nerve (1). Here, we present a case of nutritional optic neuropathy from vitamin B12 deficiency. This was the sequela of chronic oral proton pump inhibitor (PPI) use; moreover, it was found to be reversible with supplementation of vitamin B12 and cessation of the PPI.