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Inglese M, Rovaris M, Bianchi S, et al. Magnetic resonance imaging, magnetisation transfer imaging, and diffusion weighted imaging correlates of optic nerve, brain, and cervical cord damage in Leber's hereditary optic neuropathy. J Neurol Neurosurg Psychiatry. 2001;70:444-449.
Lenaers G, Hamel C, Delettre C, et al. Dominant optic atrophy. Orphanet J Rare Dis. 2012;7:46.
Gaier ED, Boudreault K, Nakata I, et al. Diagnostic genetic testing for patients with bilateral optic neuropathy and comparison of clinical features according to OPA1 mutation status. Mol Vision. 2017;23:548560.
Raxone® (idebenone) Product Information. European Medicines Agency (EMA). Published September 8, 2015. Updated August 8, 2020. Accessed March 31, 2021. https://www.ema.europa.eu/en/documents/product-information/raxone-epar-product-information_en.pdf
Yu-Wai-Man P, Soiferman D, Moore DG, et al. Evaluating the therapeutic potential of idebenone and related quinone analogues in Leber hereditary optic neuropathy. Mitochondrion. 2017;36:36-42.
Klopstock T, Yu-Wai-Man P, Dimitriadis K, et al. A randomized placebo-controlled trial of idebenone in Leber's hereditary optic neuropathy. Brain. 2011;134:2677-2686.
Carelli V, La Morgia C, Valentino ML, et al. Idebenone treatment in Leber's hereditary optic neuropathy. Brain. 2011;134:e188.
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Garcia GA, Khoshnevis M, Gale J, et al. Profound vision loss impairs psychological well-being in young and middle-aged individuals. Clin Ophthalmol. 2017;11:417-427.
Yu-Wai-Man P, Votruba M, Burte F, et al. A neurodegenerative perspective on mitochondrial optic neuropathies. Acta Neuropathol. 2016;132:789-806.
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Faculty

Catherine Vignal-Clermont, MD

Department of Emergencies and Neuro Ophthalmology
Rothschild Foundation Hospital Paris
Department of Ophthalmology
Centre National Hospitalier National d’Ophthalmologie des Quinze-Vingts
Paris, France

Disclosures

Disclosure: Catherine Vignal-Clermont, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Alexion; Gensight Biologics; Santhera Pharma
Served as a speaker or a member of a speakers bureau for: Novartis

Editors

Gillian Griffith, BA (Mod), MA

Medical Education Director, WebMD Global, LLC

Disclosures

Disclosure: Gillian Griffith, BA (Mod), MA, has disclosed no relevant financial relationships.

Frances McFarland, PhD, MA

Medical Writer, WebMD Global, LLC

Disclosures

Disclosure: Frances McFarland, PhD, MA, has disclosed no relevant financial relationships.

Content Reviewer

Robert Morris, PharmD

Associate Director, Accreditation and Compliance

Disclosures

Disclosure: Robert Morris, PharmD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: ViiV Healthcare
Owns stock, stock options, or bonds from: GlaxoSmithKline

Peer Reviewer

This activity has been peer reviewed and the reviewer has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Apellis; DeepMind Technologies Inc; Novartis; Roche
Received grants for educational activities: Allergan
Owns stock, stock options, or bonds: Big Picture Medical; BitFount

CPD

Sudden Vision Loss in Young Adults: What's Next?

Authors: Catherine Vignal-Clermont, MD
CPD Released: 7/2/2021
THIS ACTIVITY HAS EXPIRED FOR CREDIT
Valid for credit through: 7/2/2022, 11:59 PM EST

Start Activity

Target Audience and Goal Statement

This educational activity is intended for an international audience of non-US ophthalmologists and neurologists.

The goal of this activity is to increase competence in detection and differential diagnosis of Leber hereditary optic neuropathy (LHON) and to improve awareness of new treatment approaches.

Upon completion of this activity, participants will:

Have increased knowledge regarding the
- Leber hereditary optic neuropathy (LHON) clinical presentation
- LHON pathogenesis
- Current and emerging LHON therapies
Have greater competence related to
- LHON detection
- Differential diagnosis (classic LHON, optic neuritis, LHON-multiple sclerosis)

Disclosures

Faculty

Catherine Vignal-Clermont, MD

Department of Emergencies and Neuro Ophthalmology
Rothschild Foundation Hospital Paris
Department of Ophthalmology
Centre National Hospitalier National d’Ophthalmologie des Quinze-Vingts
Paris, France

Disclosures

Disclosure: Catherine Vignal-Clermont, MD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: Alexion; Gensight Biologics; Santhera Pharma
Served as a speaker or a member of a speakers bureau for: Novartis

Editors

Gillian Griffith, BA (Mod), MA

Medical Education Director, WebMD Global, LLC

Disclosures

Disclosure: Gillian Griffith, BA (Mod), MA, has disclosed no relevant financial relationships.

Frances McFarland, PhD, MA

Medical Writer, WebMD Global, LLC

Disclosures

Disclosure: Frances McFarland, PhD, MA, has disclosed no relevant financial relationships.

Content Reviewer

Robert Morris, PharmD

Associate Director, Accreditation and Compliance

Disclosures

Disclosure: Robert Morris, PharmD, has disclosed the following relevant financial relationships:
Served as an advisor or consultant for: ViiV Healthcare
Owns stock, stock options, or bonds from: GlaxoSmithKline

Peer Reviewer

Accreditation Statements

For Physicians

The Faculty of Pharmaceutical Medicine of the Royal Colleges of Physicians of the United Kingdom (FPM) has reviewed and approved the content of this educational activity and allocated it 1.25 continuing professional development credits (CPD).

Approved by The Royal College of Ophthalmologists for 1.0 CPD point.

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From Medscape Education

CPD

Sudden Vision Loss in Young Adults: What's Next?

Authors: Catherine Vignal-Clermont, MDFaculty and Disclosures

THIS ACTIVITY HAS EXPIRED FOR CREDIT

CPD Released: 7/2/2021

Valid for credit through: 7/2/2022, 11:59 PM EST

processing....

The following cases are modeled on the interactive grand rounds approach. The questions within the activity are designed to test your current knowledge. After each question, you will be able to see whether you answered correctly and read evidence-based information that supports the most appropriate answer choice. The questions are designed to challenge you; you will not be penalized for answering the questions incorrectly. At the end of the activity, there will be a short post-test assessment based on the material presented.

Clinical Case 1: Patient History

Anthony is a 25-year-old student who consumes a high amount of alcohol. He presents to his general practitioner (GP) with signs of severe, subacute central vision deterioration in both eyes. His GP refers him to an ophthalmologist. Anthony tells the ophthalmologist that he does not feel any pain, but that his sight is blurry and that colors seem faded. He also reports that he first noticed the problem in his left eye about 3 months ago but is now having problems with both eyes. The ophthalmologist questions Anthony further and learns that his maternal grandmother and two uncles also experienced vision problems at an early age. The initial examination confirms a bilateral loss of visual acuity, such that no plate of color vision is perceptible. Fundus examination reveals that the right disc looks hyperemic with peripapillary dilation of small vessels, and the temporal part of the left optic disc is pale; on both sides, the central retinal vessels look tortuous (Figure 1).

Figure 1. Ocular Fundus of the Patient

Vision loss began in the left eye and is now bilateral. The left optic disc shows pseudoedema and temporal pallor, while the right optic disc shows hyperemia, pseudoedema, and peripapillary telangiectasis. Both discs show retinal vessel tortuosity. (Photo courtesy of Catherine Vignal-Clermont, MD.)

The ophthalmologist then performs a visual field examination, which reveals bilateral central scotoma. On the optical coherence tomography (OCT), there is a thickening of the peripapillary retinal nerve fiber layer (pRNFL) on the right side and a thinning of the pRNFL on the left side; on both sides the macular ganglion cells (GC), thickness is reduced.

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The educational activity presented above may involve simulated case-based scenarios. The patients depicted in these scenarios are fictitious and no association with any actual patient is intended or should be inferred.

The material presented here does not necessarily reflect the views of WebMD Global, LLC or companies that support educational programming on medscape.org. A qualified healthcare professional should be consulted before using any therapeutic product discussed. Readers should verify all information and data before treating patients or employing any therapies described in this educational activity.

References

Faculty and Disclosures

Faculty

Catherine Vignal-Clermont, MD

Editors

Gillian Griffith, BA (Mod), MA

Frances McFarland, PhD, MA

Content Reviewer

Robert Morris, PharmD

Peer Reviewer

CPD

Sudden Vision Loss in Young Adults: What's Next?

Target Audience and Goal Statement

Disclosures

Faculty

Catherine Vignal-Clermont, MD

Editors

Gillian Griffith, BA (Mod), MA

Frances McFarland, PhD, MA

Content Reviewer

Robert Morris, PharmD

Peer Reviewer

Accreditation Statements

For Physicians

Instructions for Participation and Credit

Sudden Vision Loss in Young Adults: What's Next?

Clinical Case 1: Patient History