Is Second Eye Involvement in Leber's Hereditary Optic Neuropathy Due to Retro- Chiasmal Spread of Apoptosis?

摘要

From time to time NEURO-OPHTHALMOLOGY publishes discussions between experts on important topics in neuro-ophthalmology. In this issue David Mackey and colleagues propose a hypothesis to explain the enigma of second eye involvement in Leber's hereditary optic neuropathy (LHON). Utilizing the growth in evidence that apoptosis propagates ganglion cell death in LHON, they contend that second eye involvement is due to retro-chiasmal spread of apoptosis. Their proposition is based on 3 cases of LHON in which the onset was preceded by unilateral retinal insult, followed by a forth case documenting in detail the progressive pattern of visual field loss during first and second eye involvement. These 4 case examples are drawn from information on 350 LHON patients in Australia during a period of 20 years.