Abstract The high incidence of pernicious anemia (PA) among patients presenting with tobacco amblyopia is noted. Four patients with PA, two of whom presented initially with visual loss indistinguishable from tobacco amblyopia, and two of whom developed similar symptoms while on treatment with cyanocobalamin are described. In all four cases, the hemopoietic abnormality was restored to normal on treatment with cyanocobalamin, but visual improvement did not occur until treatment was changed to hydroxocobalamin. The significance of these findings is discussed. References 1. Freeman, A.G., and Heaton, J.M.: The Aetiology of Retrobulbar Neuritis in Addisonian Pernicious Anaemia , Lancet 1:908-911 ( (April 29) ) 1961.Crossref 2. Foulds, W.S., et al: Cyanide Induced Optic Neuropathy, Proceedings of the Third Congress of the European Society of Ophthalmology, to be published. 3. Adams, P., et al: Megaloblastic Anaemia and Vision , Lancet 2:229-231 ( (July 29) ) 1967.Crossref 4. Ross, G.I.M.: Vitamin B12 Assay in Body Fluids Using Euglena Gracilis , J Clin Path 5:250-256 ( (Aug) ) 1952.Crossref 5. Schilling, R.F.: Intrinsic Factor Studies: The Effect of Gastric Juice on the Urinary Excretion of Radioactivity After the Oral Administration of Radioactive Vitamin B12 , J Lab Clin Med 42:860-866 ( (Dec) ) 1963. 6. Watson, W.C.: Assessment of Absorption From the Small Bowel , Scot Med J 13:116-121 ( (April) ) 1968. 7. Heaton, J.M.; McCormick, A.J.; and Freeman, A.G.: Tobacco Amblyopia: A Clinical Manifestation of Vitamin B12 Deficiency , Lancet 2:286-290 ( (Aug 9) ) 1958.Crossref 8. Chisholm, I.A.; Bronte-Stewart, J.; and Foulds, W.S.: Hydroxocobalamin Versus Cyanocobalamin in the Treatment of Tobacco Amblyopia , Lancet 2:450-457 ( (Aug 26) ) 1967.Crossref 9. Wokes, S.: Tobacco Amblyopia , Lancet 2:526-527 ( (Sept 6) ) 1958.Crossref 10. Smith, A.B.M.: Retrobulbar Neuritis in Addisonian Pernicious Anaemia , Lancet 1:1001-1002 ( (May 6) ) 1961.Crossref 11. Chalmers, J.N.M., and Shinton, N.K.: Absorption of Orally Administered Vitamin B12 in Pernicious Anaemia , Lancet 2:1298-1302 ( (Dec 20) ) 1958.Crossref 12. Shinton, N.K.: The Cobalamins , Practitioner 196:859-867 ( (June) ) 1960.
Archives of Ophthalmology – American Medical Association
Published: Oct 1, 1969