Recently it has been demonstrated that serious changes can be produced within two weeks when weanling rats are placed on choline-poor diets.1 Hemorrhagic kidneys and adrenals, fatty liver, enlarged spleen and atrophied thymus are the most consistent findings. In addition, hemorrhages are frequently found in the lungs, myocardium, lymph nodes and eyes.2 The mention of ocular hemorrhages drew our attention to the possible ophthalmologic implications.
Choline (trimethylhydroxyethylammonium hydroxide) is a moderately strong base occurring as a part of the lecithin in bile, brain, egg yolk, etc. Morgan3 called it a water-soluble vitamin. It is directly active lipotropically ; i. e., it prevents development of fatty liver or accelerates the disappearance of abnormal fat from the liver4 and is concerned more indirectly in carbohydrate metabolism.5 It appears likely that choline may be involved in the metabolism of cholesterol as well as in that of neutral fat.6
BELLOWS JG, CHINN H. INTRAOCULAR HEMORRHAGES IN CHOLINE DEFICIENCY. Arch Ophthalmol. 1943;30(1):105–109. doi:10.1001/archopht.1943.00880190123012