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Case Reports
. 2021 Sep 1;41(3):316-320.
doi: 10.1097/WNO.0000000000001333.

Leber's Hereditary Optic Neuropathy in Older Individuals Because of Increased Alcohol Consumption During the COVID-19 Pandemic

Kirill Zaslavsky  1 , Edward A Margolin
Affiliations
Case Reports

Leber's Hereditary Optic Neuropathy in Older Individuals Because of Increased Alcohol Consumption During the COVID-19 Pandemic

Kirill Zaslavsky et al. J Neuroophthalmol. .

Abstract

Background: Leber's hereditary optic neuropathy (LHON) is a disorder affecting oxidative phosphorylation in mitochondria. A majority of affected patients are men of 15 to 35 years of age. Phenotypic penetrance of this condition is only 50% in man and 10% in women and increases if the cellular energy demands go up, with the most common risk factors being smoking and alcohol use.

Methods: Review of clinical features of 3 patients who were diagnosed with LHON in their sixth decade of life after doubling their alcohol intake during the recent COVID-19 pandemic.

Results: All 3 patients were older than the age of 50 when they developed severe sequential visual loss. All have at least doubled their alcohol intake for at least 4 weeks preceding visual loss, and 2 who were smokers increased the number of cigarettes consumed daily because of the stress and boredom during the lockdowns triggered by the pandemic.

Conclusions: Significant increase in substance abuse in the general population during the recent lockdowns to combat the COVID-19 pandemic is well documented. We report 3 patients older than the age of 50, one of them a woman, who developed severe bilateral visual loss due to LHON after doubling their alcohol consumption and increasing number of cigarettes smoked daily during the pandemic. Clinicians are reminded to consider LHON in the differential diagnosis when encountering older patients with bilateral sequential visual loss and to specifically inquire about alcohol use and cigarette smoking in these patients.

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Conflict of interest statement

The authors report no conflicts of interest.

References

    1. Carelli V, d'Adamo P, Valentino ML, La Morgia C, Ross-Cisneros FN, Caporali L, Maresca A, Polosa PL, Barboni P, De Negri A, Sadun F, Karanjia R, Salomao SR, Berezovsky A, Chicani F, Moraes M, Moraes Filho M, Belfort R Jr, Sadun A. Parsing the differences in affected with LHON: genetic versus environmental triggers of disease conversion. Brain. 2016;139:e17.
    1. Kisilevsky E, Freund P, Margolin E. Mitochondrial disorders and the eye. Surv Ophthalmol. 2020;65:294–311.
    1. Wallace DC, Lott MT. Leber hereditary optic neuropathy: exemplar of an mtDNA disease. In: Pharmacology of Mitochondria [Internet]. Singh H, Sheu S-S, eds. Cham: Springer International Publishing, 2017:339–376. (Handbook of Experimental Pharmacology; vol. 240).
    1. Vanderbruggen N, Matthys F, Van Laere S, Zeeuws D, Santermans L, Van den Ameele S, Crunelle CL. Self-reported alcohol, tobacco, and cannabis use during COVID-19 lockdown measures: results from a web-based survey. Eur Addict Res. 2020;26:309–315.
    1. Mansukhani SA, Mehta DG, Renaud DL, Whealy MA, Chen JJ, Bhatti MT. Nuclear DNA mutation causing a phenotypic leber hereditary optic neuropathy plus. Ophthalmology. 2021;128:628–631.

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