Leber Hereditary Optic Neuropathy Associated with Bilateral Macular Holes

ABSTRACT

Leber hereditary optic neuropathy (LHON) causes visual loss, predominantly in healthy young men. We recently examined a patient who previously had bilateral macular holes and subsequently developed LHON at 74 years of age. Although his central scotomas were initially attributed to the macular holes, his visual acuity declined following an initial improvement after operative closure of the macular holes; thus, other diagnoses, including LHON, were considered. Furthermore, macular optical coherence tomography (OCT) images remained unchanged in this time. A mitochondrial genetic analysis identified a 11778G→A mutation. From this case, we propose that LHON remains in the differential diagnosis even in older patients, as has previously been reported.

KEYWORDS:

• Central scotoma
• Leberhereditary optic neuropathy
• macular hole

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.