Proper red blood cell formation in the bone marrow, synthesis of myelin in the nervous system and DNA synthesis are some of the most important roles of Vitamin B12 in the human body. Human cells cannot synthesize Vitamin B12, however, a typical balanced diet contains an adequate amount of cobalamin. Vitamin B12: Also known as cobalamin, it is involved in metabolism.There is an important association between the lack of serum folate and the development of nutritional optic neuropathy.
In adults, reduced folate levels are related to cognitive dysfunction in elderly patients, visual system compromise in the context of nutritional amblyopia, as well as, optic atrophy and gradual decrease in vision. The main function of folate is to contribute to proper cell division, it works as a coenzyme involved in the synthesis of pyrimidines and purines. Vitamin B9: Folate is stored in the liver and doesn’t need to be ingested daily.Vitamins B12, B6 and B1, called neurotrophic vitamins, are essential to maintain the health of the nervous system, including the optic nerve. They play a critical role as coenzymes for various enzymatic reactions. Isolated deficiency of a complex B vitamin is uncommon, it usually coexists with poor diet, alcoholism and malabsorptive disorders. Vitamins of B complex are water-soluble vitamins that are present in some foods, added to a few food products, and available as dietary supplements. Some known cases are: Strachan syndrome related to nutritional deficit in Jamaican sugarcane workers in the 1880s, tropical amblyopia in Nigerians, optic neuropathy in Japanese prisoners during WWII, Cuban epidemic optic neuropathy and Tanzanian epidemic optic neuropathy. However, nowadays, there is a group of emerging patients who are at risk of developing this pathology, especially patients who have undergone bariatric surgery, are into restrictive or vegan diets. Nutritional optic neuropathy, although rare, has been documented throughout history, specifically during periods of war and famine, where it is believed to be most prevalent. The lack of these, causes an interruption of electron transport and, consequently, a reduction in ATP production, in addition to accumulation of free radicals. These optic neuropathies are often triggered by vitamin B complex déficits: vitamin B12 (cobalamin), vitamin B1 (thiamin), vitamin B2 (riboflavin) and vitamin B9 (folic acid) elements that are crucial for the processes of mitochondrial oxidative phosphorylation. Nutritional optic neuropathy is an uncommon and unrecognized cause of bilateral, symmetrical and progressive visual loss which is part of the group of metabolic neuropathies.
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