Initial temporal field defect in Leber hereditary optic neuropathy

Abstract

Purpose: To determine the site of the initial field defect in patients with Leber hereditary optic neuropathy (LHON).

Methods: We studied nine eyes of nine consecutive LHON patients with the 11778 mitochondrial DNA mutation who had no visual loss (four eyes) or only minimal visual loss (five eyes). When unilateral visual loss was observed, Humphrey field analysis (HFA) (HFA 30-2 program and sometimes the HFA 10-2 program) was immediately and repeatedly performed on the better eye.

Results: For the 12 centralmost points in the visual field, a loss of sensitivity (P<0.02) was initially found in the upper temporal field of nine eyes and in the lower temporal field of three eyes. These results indicate that it was possible to detect the initial site of sensitivity loss in the centralmost temporal test points in all nine cases. The HFA 10-2 program confirmed the sensitivity loss in the temporal field in two cases.

Conclusions: The centralmost temporal visual field appears to be the most susceptible site in eyes of LHON patients. This suggests that the most susceptible cells during the early stages of LHON are the retinal ganglion cells located in the corresponding region of the retina.