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TL;DR
Two liver transplant candidates with alcohol-associated cirrhosis developed vitamin A deficiency-related corneal epithelial defects, and high-dose vitamin A supplementation led to corneal healing in both patients.
ACG Case Reports Journal · 5 authors, 3 centres
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Two liver transplant candidates with alcohol-associated cirrhosis developed vitamin A deficiency-related corneal epithelial defects, and high-dose vitamin A supplementation led to corneal healing in both patients.
This case report describes two male patients (ages 31 and 28) with alcohol-associated cirrhosis who were candidates for liver transplantation and developed nonhealing central corneal epithelial defects without typical xerophthalmia findings. Both were treated with oral/parenteral high-dose vitamin A supplementation. The first patient's defect healed with scarring after several weeks, complicated by exposure keratopathy and a prolonged ICU course after liver transplantation. The authors note that VAD may present as acute, nonclassical ocular findings before progressing to xerophthalmia, and suggest screening all liver transplant candidates for VAD.