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Leber hereditary optic neuropathy

Lookup NU author(s): Dr Patrick Yu Wai Man, Emeritus Professor Doug Turnbull, Professor Patrick Chinnery

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Abstract

Leber hereditary optic neuropathy (LHON) is a mitochondrial genetic disease that preferentially causes blindness in young adult males, affecting about 1 in 25 000 of the British population. It is characterised by bilateral subacute loss of central vision owing to focal degeneration of the retinal ganglion cell layer and optic nerve. Over 95% of LHON cases are primarily the result of one of three mitochondrial DNA (mtDNA) point mutations, G3460A, G11778A, and T14484C, which all involve genes encoding complex I subunits of the respiratory chain. An intriguing feature of LHON is that only approximately 50% of males and approximately 10% of females who harbour a pathogenic mtDNA mutation actually develop the optic neuropathy. This marked incomplete penetrance and gender bias imply that additional mitochondrial and/or nuclear genetic factors must be modulating the phenotypic expression of LHON. It is also likely that environmental factors contribute to the onset of visual failure. However, these secondary precipitating factors remain poorly defined at present. In this review, we describe the natural history of this optic nerve disorder and highlight issues relating to clinical diagnosis, management, and genetic counselling. We also discuss the findings of recently published studies and the light they shed on the complex aetiology and pathophysiology of LHON.


Publication metadata

Author(s): Yu Wai Man P, Turnbull DM, Chinnery PF

Publication type: Article

Publication status: Published

Journal: Journal of Medical Genetics

Year: 2002

Volume: 39

Issue: 3

Pages: 162-169

ISSN (print): 0022-2593

ISSN (electronic): 1468-6244

Publisher: BMJ Group

URL: http://dx.doi.org/10.1136/jmg.39.3.162

DOI: 10.1136/jmg.39.3.162

Notes: 1468-6244 Journal Article Review Review, Tutorial


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