Background: The visual prognosis in Leber hereditary optic neuropathy (LHON) is generally poor. However, some individuals can have spontaneous visual recovery (VR) in one or both eyes by a mechanism that is not yet clearly understood. The purpose of this study was to determine whether certain clinical and optic disc features are associated with VR in patients with LHON.
Methods: We retrospectively examined 80 eyes of 40 patients with LHON using clinical databases, fundus photographs, and high-definition spectral-domain optical coherence tomography (OCT) images. VR was defined as a gain of 3 or more lines of logarithm of the minimum angle of resolution (logMAR)-scaled visual acuity from nadir; this represents a doubling of the visual angle. Patients were divided into VR and nonrecovery (NR) groups. Using fundus photographs, we measured optic disc size and evaluated for the presence of optic disc features, including peripapillary telangiectasia, disc hyperemia, and swelling. We also measured the disc area, cup-to-disc ratio, and rim area of the optic disc using OCT.
Results: Twenty-one of 80 eyes (26%) had a VR. The VR occurred within 2 years after onset in 81% of cases. The VR group showed younger age at onset (21 vs 29 years, P = 0.017) and better visual acuity at the nadir (1.39 vs 2.16 logMAR, P < 0.001) compared with the NR group. Optic disc features, particularly peripapillary telangiectasia (P = 0.027) and disc hyperemia (P = 0.006), were more prominent in the NR group. The cup-to-disc ratio was significantly smaller (0.64 vs 0.71, P = 0.004) and the rim area was significantly greater (1.17 vs 0.85 mm, P < 0.001) in the VR group compared with the NR group.
Conclusions: A younger age at onset and a less severe reduction of visual acuity at the nadir were associated with a higher probability of VR. Presence of peripapillary telangiectasia and optic disc hyperemia may serve as predictive factors for poor visual prognosis in patients with LHON.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/WNO.0000000000000830 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Ophthalmic Complications Associated With the Antidiabetic Drugs Semaglutide and Tirzepatide.
JAMA Ophthalmol
January 2025
John A. Moran Eye Center, Department of Ophthalmology & Visual Sciences, Department of Neurology, University of Utah Health, Salt Lake City.
Importance: Nearly 2% of the US population received a prescription for semaglutide in 2023. There has been a recent concern that this drug and other similar medications may be associated with ophthalmic complications.
Objective: To report ophthalmic complications associated with the use of semaglutide or tirzepatide.
A Case of AQP4-IgG Neuromyelitis Optica Presenting with Orbital Inflammatory Syndrome.
Ocul Immunol Inflamm
January 2025
Ruiz Department of Ophthalmology and Visual Science, McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USA.
A 45-year-old healthy African-American man experienced 2 months of right-eye soreness followed by acute onset of right painful vision loss with binocular, oblique diplopia. Visual acuity was count fingers OD and 20/20 OS. He had a partial, right, pupil-involving cranial nerve III palsy with a right relative afferent pupillary defect and optic disc edema with tortuous vessels.
View Article and Find Full Text PDFTherapeutic Dilemma of a Juxtapapillary Retinal Capillary Hemangioma.
Cureus
December 2024
Department of Ophthalmology and Visual Science, Ophthalmology Clinic, Hospital Universiti Sains Malaysia, Universiti Sains Malaysia, Kubang Kerian, MYS.
A juxtapapillary retinal capillary hemangioma (JRCH) is a rare vascular hamartoma located on the optic nerve head or adjacent region. While often associated with von Hippel-Lindau (VHL) disease, JRCHs can also occur as an isolated condition, presenting unique therapeutic challenges and risks of visual impairment. We report a case of a 50-year-old Malay gentleman with diabetes mellitus who presented with a non-progressive superior visual field defect in his left eye for three months.
View Article and Find Full Text PDFPerformance of Optic Disc Optical Coherence Tomography Normative Database in a Large, Diverse, Real-World Cohort.
J Glaucoma
January 2025
Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI.
Precis: Current optical coherence tomography normative sample data may not represent diverse human optic nerve anatomy to accurately classify all individuals with true glaucomatous optic neuropathy.
Purpose: To compare optic nerve head (ONH) measurements between published values from an optical coherence tomography (OCT) normative database and a more diverse cohort of healthy individuals.
Patients And Methods: ONH parameters from healthy participants of the Michigan Screening and Intervention for Glaucoma and Eye Health through Telemedicine (MI-SIGHT) program and the Topcon Maestro-1 normative cohort were compared.
Glaucoma Detection and Feature Identification via GPT-4V Fundus Image Analysis.
Ophthalmol Sci
November 2024
Division of Ophthalmology Informatics and Data Science, Viterbi Family Department of Ophthalmology, Shiley Eye Institute, University of California, San Diego, La Jolla, California.
Purpose: The aim is to assess GPT-4V's (OpenAI) diagnostic accuracy and its capability to identify glaucoma-related features compared to expert evaluations.
Design: Evaluation of multimodal large language models for reviewing fundus images in glaucoma.
Subjects: A total of 300 fundus images from 3 public datasets (ACRIMA, ORIGA, and RIM-One v3) that included 139 glaucomatous and 161 nonglaucomatous cases were analyzed.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!