Visual function improvement after idebenone therapy in Leber hereditary optic neuropathy

Purpose There is still no therapy for patients with Leber hereditary optic neuropathy (LHON). Recent studies have confirmed the effectiveness of Idebenone for the treatment of specific groups of LHON patients. However, it is still unclear if this treatment can be interesting in all cases of LHON. We wanted to evaluate whether Idebenone therapy in association with vitamin B2 and vitamin C can modify the visual function in non selected LHON patients. Methods A retrospective review of visual acuity and Goldmann visual field performed in patients referred to the ophthalmology clinic for LHON before and after a therapy with Idebenone (up to 270 mg/day), vitamin B2 and vitamin C. Results Seventy five patients were included. Mean duration between LHON onset and inclusion was 36 months. Mean treatment duration was 25 months. Twenty seven per cent of patients presented visual improvement. A surface reduction of the central scotoma greater than 30 % was observed in 36.2 % of these patients. Conclusion There is an effect of Idebenone therapy on visual function of LHON patients. Due to the delay between symptoms onset and beginning of the treatment, improvement does not seem to be due to habituation to low vision. However, Idebenone therapy is unable to correct visual disability in LHON population.