Long-Term Evaluation of Visual Field Alteration in Leber's Hereditary Optic Neuropathy with Visual Recovery

Abstract

A 14-year-old girl who was diagnosed as having Leber's hereditary optic neuropathy with the 11778 mutation in the mitochondrial DNA was followed up by investigating the visual field alteration periodically over a three-year period. She was first seen with a sudden decrease of visual acuity in the right eye. Goldmann's perimetry showed a large central scotoma in the right eye and small relative scotomas in the upper part of the left eye which was still asymptomatic. Visual acuity in the left eye, however, decreased two months later. At that time, a large absolute central scotoma was detected. The absolute central scotomas in both eyes gradually shrank to change to a relative one in one and a half years after the onset, sequentially leading to an increase of visual acuity which was finally 0.15 OD and 1.0 OS. The long-term evaluation in our case indicated that the development of visual field changes was almost identical in both eyes and that slow recovery of visual acuity was a result of the gradual shrinkage to breakthrough of central scotoma.

KEYWORDS:

• Leber's hereditary optic neuropathy
• Goldmann perimetry
• 11778 mutation
• visual field alteration