Childhood-Onset Leber Hereditary Optic Neuropathy: Particular Features
Ana Maria Cunha,1 Rodrigo Vilares-Morgado,1 Ana Filipa Moleiro,1 Fernando Falcão-Reis,1,2 Olinda Faria1,2 1Department of Ophthalmology, Centro Hospitalar Universitário de São João, Porto, Portugal; 2Department of Surgery and Physiology, Faculty of Medicine...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2021-03-01
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| Series: | International Medical Case Reports Journal |
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| Online Access: | https://www.dovepress.com/childhood-onset-leber-hereditary-optic-neuropathy-particular-features-peer-reviewed-article-IMCRJ |
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| author | Cunha AM Vilares-Morgado R Moleiro AF Falcão-Reis F Faria O |
| author_facet | Cunha AM Vilares-Morgado R Moleiro AF Falcão-Reis F Faria O |
| author_sort | Cunha AM |
| collection | DOAJ |
| description | Ana Maria Cunha,1 Rodrigo Vilares-Morgado,1 Ana Filipa Moleiro,1 Fernando Falcão-Reis,1,2 Olinda Faria1,2 1Department of Ophthalmology, Centro Hospitalar Universitário de São João, Porto, Portugal; 2Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, PortugalCorrespondence: Ana Maria CunhaDepartment of Ophthalmology, Centro Hospitalar Universitário de São João, Avenida Prof. Hernâni Monteiro, Porto, 4202 – 451, PortugalTel +35 1225512100Fax +35 1225513669Email ana.cunha.18@gmail.comBackground: Leber hereditary optic neuropathy (LHON) is an optic neuropathy of mitochondrial inheritance. Childhood-onset disease is relatively rare and there are limited data on this important patient subgroup.Case Presentation: We present 3 particular presentations of LHON. Patient 1 was an 8-year-old boy admitted to the emergency department reporting a progressive bilateral visual loss and intermittent headaches. Neuro-ophthalmological examination revealed a bilateral pseudopapilledema. Lumbar puncture identified intracranial hypertension and the brain and orbits magnetic resonance imaging showed T2 hyperintensity in the posterior region of the left optic nerve and the optic chiasm. Patient 2 was a 12-year-old boy admitted to the emergency department reporting painless, progressive central vision loss in the right eye. Fundus examination revealed a hyperemic disc and vascular network papillary and peripapillary vascular microdilations. Three months later, the left eye presented visual loss. Patient 3 was a 6-year-old female child referred to the neuro-ophthalmology specialist due to painless central visual loss in both eyes. Her BCVA was 1/10 and counting fingers in right and left eye, respectively, and fundus examination revealed a pallor optic disc in the temporal sector.Discussion: The phenotype of childhood-onset disease may present itself distinct from classical adult-onset LHON. The absence of classical clinical features could lead to initial misdiagnosis. There should exist a high index of suspicion in children presenting unexplained subnormal vision in order to avoid potential diagnostic delays.Keywords: Leber hereditary optic neuropathy, childhood-onset disease, mitochondrial inheritance |
| first_indexed | 2024-12-19T22:47:30Z |
| format | Article |
| id | doaj.art-99b5f7883f364053a6b58a6c2587c423 |
| institution | Directory Open Access Journal |
| issn | 1179-142X |
| language | English |
| last_indexed | 2024-12-19T22:47:30Z |
| publishDate | 2021-03-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Medical Case Reports Journal |
| spelling | doaj.art-99b5f7883f364053a6b58a6c2587c4232022-12-21T20:02:55ZengDove Medical PressInternational Medical Case Reports Journal1179-142X2021-03-01Volume 1416316963007Childhood-Onset Leber Hereditary Optic Neuropathy: Particular FeaturesCunha AMVilares-Morgado RMoleiro AFFalcão-Reis FFaria OAna Maria Cunha,1 Rodrigo Vilares-Morgado,1 Ana Filipa Moleiro,1 Fernando Falcão-Reis,1,2 Olinda Faria1,2 1Department of Ophthalmology, Centro Hospitalar Universitário de São João, Porto, Portugal; 2Department of Surgery and Physiology, Faculty of Medicine, University of Porto, Porto, PortugalCorrespondence: Ana Maria CunhaDepartment of Ophthalmology, Centro Hospitalar Universitário de São João, Avenida Prof. Hernâni Monteiro, Porto, 4202 – 451, PortugalTel +35 1225512100Fax +35 1225513669Email ana.cunha.18@gmail.comBackground: Leber hereditary optic neuropathy (LHON) is an optic neuropathy of mitochondrial inheritance. Childhood-onset disease is relatively rare and there are limited data on this important patient subgroup.Case Presentation: We present 3 particular presentations of LHON. Patient 1 was an 8-year-old boy admitted to the emergency department reporting a progressive bilateral visual loss and intermittent headaches. Neuro-ophthalmological examination revealed a bilateral pseudopapilledema. Lumbar puncture identified intracranial hypertension and the brain and orbits magnetic resonance imaging showed T2 hyperintensity in the posterior region of the left optic nerve and the optic chiasm. Patient 2 was a 12-year-old boy admitted to the emergency department reporting painless, progressive central vision loss in the right eye. Fundus examination revealed a hyperemic disc and vascular network papillary and peripapillary vascular microdilations. Three months later, the left eye presented visual loss. Patient 3 was a 6-year-old female child referred to the neuro-ophthalmology specialist due to painless central visual loss in both eyes. Her BCVA was 1/10 and counting fingers in right and left eye, respectively, and fundus examination revealed a pallor optic disc in the temporal sector.Discussion: The phenotype of childhood-onset disease may present itself distinct from classical adult-onset LHON. The absence of classical clinical features could lead to initial misdiagnosis. There should exist a high index of suspicion in children presenting unexplained subnormal vision in order to avoid potential diagnostic delays.Keywords: Leber hereditary optic neuropathy, childhood-onset disease, mitochondrial inheritancehttps://www.dovepress.com/childhood-onset-leber-hereditary-optic-neuropathy-particular-features-peer-reviewed-article-IMCRJleber hereditary optic neuropathychildhood-onset diseasemitochondrial inheritance |
| spellingShingle | Cunha AM Vilares-Morgado R Moleiro AF Falcão-Reis F Faria O Childhood-Onset Leber Hereditary Optic Neuropathy: Particular Features International Medical Case Reports Journal leber hereditary optic neuropathy childhood-onset disease mitochondrial inheritance |
| title | Childhood-Onset Leber Hereditary Optic Neuropathy: Particular Features |
| title_full | Childhood-Onset Leber Hereditary Optic Neuropathy: Particular Features |
| title_fullStr | Childhood-Onset Leber Hereditary Optic Neuropathy: Particular Features |
| title_full_unstemmed | Childhood-Onset Leber Hereditary Optic Neuropathy: Particular Features |
| title_short | Childhood-Onset Leber Hereditary Optic Neuropathy: Particular Features |
| title_sort | childhood onset leber hereditary optic neuropathy particular features |
| topic | leber hereditary optic neuropathy childhood-onset disease mitochondrial inheritance |
| url | https://www.dovepress.com/childhood-onset-leber-hereditary-optic-neuropathy-particular-features-peer-reviewed-article-IMCRJ |
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