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Nutritional optic neuropathy — Clinical Guidelines

Overview

Nutritional optic neuropathy (NON) is a condition characterized by optic nerve dysfunction resulting from deficiencies in essential nutrients such as vitamins (especially B vitamins, vitamin A) and minerals (like iron and copper), leading to vision impairment and potentially irreversible damage 40 20.

Diagnosis

Clinical Presentation: Visual acuity loss, visual field defects, optic disc swelling or pallor 40.

Recommended Tests:

- Blood tests for deficiencies in vitamins B12, folate, B6, vitamin A, iron, and copper levels 40 20. - Fundus examination to assess optic disc appearance 40.

Grading: Often assessed based on severity of visual impairment and optic nerve changes, though standardized grading systems are not universally adopted 40.

Management

First-Line Treatments:

- Supplementation with deficient nutrients: high-dose oral or parenteral vitamin B12, folate, iron, and copper as indicated by laboratory results 40 20. - Correction of underlying nutritional deficiencies through dietary modifications and fortified foods 1 14 29.

Adjunctive Treatments:

- Monitoring and management of any underlying conditions contributing to malnutrition 40. - Regular ophthalmologic follow-up to assess recovery and prevent further damage 40.

Special Populations

Pregnancy: Folic acid and iron supplementation are crucial to prevent NON in pregnant women and their offspring 3 18.

Pediatrics: Early identification and intervention with multivitamin supplementation can mitigate developmental impacts 3 16 33.

Elderly: Increased risk due to dietary restrictions and absorption issues; tailored nutritional support and regular screening recommended 20 49.

Comorbidities: Individuals with chronic diseases requiring restrictive diets (e.g., renal failure) need careful monitoring and supplementation to prevent deficiencies 20 45.

Key Recommendations

Identify and Correct Nutritional Deficiencies: Regular blood tests to assess levels of vitamins B12, folate, B6, vitamin A, iron, and copper; initiate targeted supplementation based on deficiencies identified 40 20 (Evidence: Strong).

Implement Fortified Foods and Supplements: Utilize fortified staple foods and multivitamin supplements, especially in populations at high risk for malnutrition 1 14 29 (Evidence: Moderate).

Monitor and Manage Underlying Conditions: Address any underlying health issues contributing to malnutrition, ensuring comprehensive care 40 (Evidence: Moderate).

Regular Ophthalmologic Follow-Up: Schedule periodic eye examinations to monitor optic nerve health and visual function recovery 40 (Evidence: Expert opinion).

References

1 Patil SA, Udachan IS, Lokhande SM, Ranveer RC, Mote GV, Khandekar SP. Effect of inhibitors on flour fortification: a nutritional approach. Journal of the science of food and agriculture 2026. link 2 Brown KH, Hess SY, Moore SE, Combs GF, Cashman KD, McNulty H et al.. Neglected micronutrients-considering a broader set of vitamins and minerals in public health nutrition programs worldwide: a narrative review. The American journal of clinical nutrition 2025. link 3 Shinde S, Yelverton CA, Yussuf M, Nurhussien L, Wang D, Fawzi WW. Effects of vitamin and multiple micronutrient supplementation for pregnant and/or lactating women on maternal and infant nutritional status in low- and middle-income countries: a systematic review and meta-analysis. Advances in nutrition (Bethesda, Md.) 2025. link 4 England E, Cheng C. Nutrition: Micronutrients. FP essentials 2024. link 5 Berger MM, Shenkin A. Micronutrient deficiency and supplements in schoolchildren and teenagers. Current opinion in clinical nutrition and metabolic care 2024. link 6 Pavlak CDR, Drehmer M, Mengue SS. Dietary Intake of Micronutrients and Use of Vitamin and/or Mineral Supplements: Brazilian National Food Survey. Nutrients 2024. link 7 Holani R, Littlejohn PT, Edwards K, Petersen C, Moon KM, Stacey RG et al.. A Murine Model of Maternal Micronutrient Deficiencies and Gut Inflammatory Host-microbe Interactions in the Offspring. Cellular and molecular gastroenterology and hepatology 2024. link 8 Nguyen LT, Nam KD, Duong PT, Pham TCT, Komatsu Y. Enhancing Nutritional Status and Addressing Micronutrient Deficiencies: Evaluating the Impact of Workplace Nutrition Program on Female Workers in Vietnam. Journal of nutritional science and vitaminology 2024. link 9 Li J, Martin C, Fernie A. Biofortification's contribution to mitigating micronutrient deficiencies. Nature food 2024. link 10 Hermes Sales C, de Mello Fontanelli M, Macedo Rogero M, Mori Sarti F, Fisberg RM. Dietary inadequacies overestimate the blood deficiencies of magnesium, zinc, and vitamins A, C, E, and D among residents of Sao Paulo. Clinical nutrition ESPEN 2023. link 11 Ara G, Little DC, Mamun AA, de Roos B, Grieve E, Khanam M et al.. Factors affecting the micronutrient status of adolescent girls living in complex agro-aquatic ecological zones of Bangladesh. Scientific reports 2023. link 12 Razavi R, Xue G. Predicting Unreported Micronutrients From Food Labels: Machine Learning Approach. Journal of medical Internet research 2023. link 13 Padonou SW, Houngbédji M, Hounhouigan MH, Chadare FJ, Hounhouigan DJ. B-vitamins and heat processed fermented starchy and vegetable foods in sub-Saharan Africa: A review. Journal of food science 2023. link 14 Duggal M, Sesikeran B, Arlappa N, Nair S, Shekhar V, Sabharwal V. Large-scale staple food fortification as a complementary strategy to address vitamin and mineral vulnerabilities in India: A critical review. Indian journal of public health 2022. link 15 Barone M, D'Amico F, Brigidi P, Turroni S. Gut microbiome-micronutrient interaction: The key to controlling the bioavailability of minerals and vitamins?. BioFactors (Oxford, England) 2022. link 16 Al-Hussaini AA, Alshehry Z, AlDehaimi A, Bashir MS. Vitamin D and iron deficiencies among Saudi children and adolescents: A persistent problem in the 21. Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association 2022. link 17 Castela Forte J, Gannamani R, Folkertsma P, Kanthappu S, van Dam S, Wolffenbuttel BHR. A Pilot Study on the Prevalence of Micronutrient Imbalances in a Dutch General Population Cohort and the Effects of a Digital Lifestyle Program. Nutrients 2022. link 18 Puri S, Rekhi TK, Thomas T, Jadhav MH, Mannar V, Diosady LL. Sensory Trial of Quintuple Fortified Salt-Salt Fortified With Iodine, Iron, Folic Acid, Vitamin B. Food and nutrition bulletin 2022. link 19 Alam MK, Sams S, Khan MS, Azmir J, Ahsan M, Akhtaruzzaman M et al.. Profiling of minerals, water soluble vitamins and carotenoid in selected unconventional leafy and non-leafy vegetables of Bangladesh. Natural product research 2022. link 20 Venkatesh U, Sharma A, Ananthan VA, Subbiah P, Durga R. Micronutrient's deficiency in India: a systematic review and meta-analysis. Journal of nutritional science 2021. link 21 Swareldhab ESE, Al-Jawaldeh A, Qureshi AB, Ali AME, Abu-Manga M, Al-Areeqi M et al.. Assessment of Micronutrient Situation among Reproductive-Age Women (15-49) and Under-Five Children in Sudan. Nutrients 2021. link 22 Gkouskou KK, Grammatikopoulou MG, Vlastos I, Sanoudou D, Eliopoulos AG. Genotype-guided dietary supplementation in precision nutrition. Nutrition reviews 2021. link 23 Barkhidarian B, Roldos L, Iskandar MM, Saedisomeolia A, Kubow S. Probiotic Supplementation and Micronutrient Status in Healthy Subjects: A Systematic Review of Clinical Trials. Nutrients 2021. link 24 Kebede D, Mengesha W, Menkir A, Abe A, Garcia-Oliveira AL, Gedil M. Marker based enrichment of provitamin A content in two tropical maize synthetics. Scientific reports 2021. link 25 Kruger J, Taylor JRN, Ferruzzi MG, Debelo H. What is food-to-food fortification? A working definition and framework for evaluation of efficiency and implementation of best practices. Comprehensive reviews in food science and food safety 2020. link 26 Suchdev PS, Jefferds MED, Ota E, da Silva Lopes K, De-Regil LM. Home fortification of foods with multiple micronutrient powders for health and nutrition in children under two years of age. The Cochrane database of systematic reviews 2020. link 27 Saha S, Roy A. Whole grain rice fortification as a solution to micronutrient deficiency: Technologies and need for more viable alternatives. Food chemistry 2020. link 28 Frankenfeld CL, Wallace TC. Multivitamins and Nutritional Adequacy in Middle-Aged to Older Americans by Obesity Status. Journal of dietary supplements 2020. link 29 Peña-Rosas JP, Mithra P, Unnikrishnan B, Kumar N, De-Regil LM, Nair NS et al.. Fortification of rice with vitamins and minerals for addressing micronutrient malnutrition. The Cochrane database of systematic reviews 2019. link 30 Wallace TC, Frankenfeld CL, Frei B, Shah AV, Yu CR, van Klinken BJ et al.. Multivitamin/Multimineral Supplement Use is Associated with Increased Micronutrient Intakes and Biomarkers and Decreased Prevalence of Inadequacies and Deficiencies in Middle-Aged and Older Adults in the United States. Journal of nutrition in gerontology and geriatrics 2019. link 31 Das JK, Salam RA, Mahmood SB, Moin A, Kumar R, Mukhtar K et al.. Food fortification with multiple micronutrients: impact on health outcomes in general population. The Cochrane database of systematic reviews 2019. link 32 Blancquaert D, De Steur H, Gellynck X, Van Der Straeten D. Metabolic engineering of micronutrients in crop plants. Annals of the New York Academy of Sciences 2017. link 33 Adams AM, Ahmed R, Latif AH, Rasheed S, Das SK, Hasib E et al.. Impact of fortified biscuits on micronutrient deficiencies among primary school children in Bangladesh. PloS one 2017. link 34 Mejia LA, Dary O, Boukerdenna H. Global regulatory framework for production and marketing of crops biofortified with vitamins and minerals. Annals of the New York Academy of Sciences 2017. link 35 Deavenport-Saman A, Britt A, Smith K, Jacobs RA. Milestones and controversies in maternal and child health: examining a brief history of micronutrient fortification in the US. Journal of perinatology : official journal of the California Perinatal Association 2017. link 36 Zanga D, Capell T, Zhu C, Christou P, Thangaraj H. Freedom-to-operate analysis of a transgenic multivitamin corn variety. Plant biotechnology journal 2016. link 37 Kumar J, Gupta DS, Kumar S, Gupta S, Singh NP. Current Knowledge on Genetic Biofortification in Lentil. Journal of agricultural and food chemistry 2016. link 38 Tran VK, Spohrer R, LE TD, Poonawala A, Monech-Pfanner R. Micronutrient Deficiency Control in Vietnam from Policy and Research to Implementation: Keys for Success, Challenges and Lessons Learned. Journal of nutritional science and vitaminology 2015. link 39 Downie LE, Barrett C, Keller PR. The personal nutrition-related attitudes and behaviors of Australian optometrists: is there evidence for an evidence-based approach?. Nutrition (Burbank, Los Angeles County, Calif.) 2015. link 40 Sawicka-Pierko A, Obuchowska I, Mariak Z. Nutritional optic neuropathy. Klinika oczna 2014. link 41 Anzid K, Baali A, Vimard P, Levy-Desroches S, Cherkaoui M, López PM. Inadequacy of vitamins and minerals among high-school pupils in Ouarzazate, Morocco. Public health nutrition 2014. link 42 Sanahuja G, Farré G, Berman J, Zorrilla-López U, Twyman RM, Capell T et al.. A question of balance: achieving appropriate nutrient levels in biofortified staple crops. Nutrition research reviews 2013. link 43 Laillou A, Pham TV, Tran NT, Le HT, Wieringa F, Rohner F et al.. Micronutrient deficits are still public health issues among women and young children in Vietnam. PloS one 2012. link 44 Johnson QW, Wesley AS. Miller's best/enhanced practices for flour fortification at the flour mill. Food and nutrition bulletin 2010. link 45 Ramakrishnan U, Neufeld LM, Flores R, Rivera J, Martorell R. Multiple micronutrient supplementation during early childhood increases child size at 2 y of age only among high compliers. The American journal of clinical nutrition 2009. link 46 Steyn NP, Wolmarans P, Nel JH, Bourne LT. National fortification of staple foods can make a significant contribution to micronutrient intake of South African adults. Public health nutrition 2008. link 47 Chen K, Li TY, Chen L, Qu P, Liu YX. Effects of vitamin A, vitamin A plus iron and multiple micronutrient-fortified seasoning powder on preschool children in a suburb of Chongqing, China. Journal of nutritional science and vitaminology 2008. link 48 van den Briel T, Cheung E, Zewari J, Khan R. Fortifying food in the field to boost nutrition: case studies from Afghanistan, Angola, and Zambia. Food and nutrition bulletin 2007. link 49 Taylor JP, Maclellan DL, van Til L, Sweet L. Widespread micronutrient inadequacies among adults in prince edward island. Canadian journal of dietetic practice and research : a publication of Dietitians of Canada = Revue canadienne de la pratique et de la recherche en dietetique : une publication des Dietetistes du Canada 2007. link 50 Shenkin A. Micronutrients in health and disease. Postgraduate medical journal 2006. link 51 Sivakumar B, Nair KM, Sreeramulu D, Suryanarayana P, Ravinder P, Shatrugna V et al.. Effect of micronutrient supplement on health and nutritional status of schoolchildren: biochemical status. Nutrition (Burbank, Los Angeles County, Calif.) 2006. link 52 Vinod Kumar M, Rajagopalan S. Impact of a multiple-micronutrient food supplement on the nutritional status of schoolchildren. Food and nutrition bulletin 2006. link 53 Biesalski HK, Brummer RJ, König J, O'Connell MA, Ovesen L, Rechkemmer G et al.. Micronutrient deficiencies. Hohenheim Consensus Conference. European journal of nutrition 2003. link 54 Thu BD, Schultink W, Dillon D, Gross R, Leswara ND, Khoi HH. Effect of daily and weekly micronutrient supplementation on micronutrient deficiencies and growth in young Vietnamese children. The American journal of clinical nutrition 1999. link 55 Fell GS, Talwar D. Assessment of status. Current opinion in clinical nutrition and metabolic care 1998. link 56 Mertz W. Food fortification in the United States. Nutrition reviews 1997. link 57 Bouis H. Enrichment of food staples through plant breeding: a new strategy for fighting micronutrient malnutrition. Nutrition reviews 1996. link

Nutritional optic neuropathy