Do idebenone and
vitamin therapy shorten the time to achieve visual recovery in Leber
hereditary optic neuropathy?
Mashima Y, Kigasawa K, Wakakura M, Oguchi Y.
Department of Ophthalmology,
Keio University School of Medicine, Tokyo, Japan.
J Neuroophthalmol 2000 Sep;20(3):166-70
Abstract
OBJECTIVES: The authors investigated the effectiveness of idebenone combined
with vitamin B2 and vitamin C in the treatment of patients with Leber
hereditary optic neuropathy (LHON) in an early stage as compared with
untreated patients with LHON. These agents may stimulate the formation of ATP.
MATERIALS AND METHODS: For this retrospective study, the authors selected 28
outpatients with LHON from the Keio University Hospital. These patients were
followed for 2 to 19 years from disease onset. They were divided into two
groups: 14 untreated patients (11778 mutation in 10 patients, 3460 mutation in
2 patients, and 14484 mutation in 2 two patients); and 14 treated patients
(11778 mutation in 11 patients, 3460 mutation in 1 patient, and 14484 mutation
in 2 patients). The treated patients were administered medical treatment with
idebenone, vitamin B2, and vitamin C for at least 1 year. The current study
evaluated the following:
1) number of eyes with visual recovery > or = 0.3;
2) interval between the onset of LHON and the beginning of visual recovery;
3)
interval between the onset of LHON and visual recovery to 0.3; and
4) interval
between the beginning of medical treatment and the beginning of visual
recovery in the treated subjects.
RESULTS: There was no significant difference
in the number of eyes with visual recovery > or = 0.3 in the two groups
with the 3460, 11778, or 14484 mutation. Patients with visual recovery showed
a fenestrated scotoma or a clearing of central vision. The mean interval
between the onset of LHON and the beginning of visual recovery was
significantly shorter in the treated group (11.1 months) than in the untreated
group (17.4 months) (P = 0.03). The mean interval between the onset of LHON
and visual recovery to 0.3 was significantly shorter in the treated group
(17.6 months) than in the untreated group (34.4 months) (P = 0.01). The mean
interval between the initiation of medical treatment to the beginning of
visual recovery was 5.4 months.
CONCLUSIONS: Results suggest that the
administration of idebenone, vitamin B2, and vitamin C sped the recovery of
vision in patients with Leber
hereditary optic neuropathy.
