The patient was a 28 year old man with a history of severe alcohol abuse and poor nutrition who presented with decreased vision in both eyes for about two months. He was otherwise in good health. He denied using non-commercially produced alcoholic beverages. His past medical history was otherwise unremarkable.
The visual acuity was 20/400 OD and 20/200 OS. The clinical examination was unremarkable, except for the appearance of the optic discs. The visual field test, which had many fixation losses attributable to the decreased visual acuity, showed a cecocentral scotoma in each eye. What was the most likely diagnosis? What treatment, if any, would you recommend?