title: [Leber's hereditary optic neuropathy and its possible relation to a recent epidemic in Cuba].
abstract: BACKGROUND
  This century, the greatest epidemic affecting the nervous system was notified in Cuba seven years ago. At the present time the epidemic continues although to a lesser extent. The clinical findings of the illness were mainly bilateral optic neuropathy sometimes accompanied by other symptoms and peripheral neuropathy. The similarity of the optic form of the illness with Leber's hereditary optic neuropathy, and their common risk factors, were obvious from the beginning.
  
  
  METHODS
  Statistics from the national reference department of neuro-ophthalmology of the Instituto de Neurologia de Cuba were reviewed. From these it was evident that the number of cases of Leber's hereditary optic neuropathy had increased in recent years, coinciding with the period of epidemic and endemic Cuban neuropathy. Many of these patients had previously been diagnosed as having epidemic optic neuropathy.
  
  
  RESULTS
  We describe the characteristics of a group of these patients and discuss the differences and possible relationship between the two conditions. In the case of epidemic optic neuropathy, there is strikingly simultaneous loss of vision, less visual changes with much smaller cecocentral scotomas, loss of ganglion fibres of the retina around the papillomacular bundle, a good response to multivitamin treatment, and increased frequency of association with peripheral sensory neuropathy.
  
  
  CONCLUSIONS
  This analysis reinforces the hypothesis that many patients with Leber's hereditary optic neuropathy, which started at the time of the epidemic, were incorrectly classified as suffering from this, and also perhaps their condition worsened due to the toxic nutritional features common to both conditions.
authors.affiliation: Servicio de Neuroftalmología, Instituto de Neurología y Neurocirugía (INN), La Habana, Cuba. lis@infomed.sld.cu
authors.forename: R
authors.initials: R
authors.lastname: Santiesteban-Freixas
authors.forename: M
authors.initials: M
authors.lastname: Rodríguez-Hernández
authors.forename: M
authors.initials: M
authors.lastname: Hirano
authors.forename: M
authors.initials: M
authors.lastname: Francisco-Plasencia
authors.forename: C
authors.initials: C
authors.lastname: Mendoza-Santiesteban
authors.forename: M
authors.initials: M
authors.lastname: Carrero-Salgado
authors.forename: I
authors.initials: I
authors.lastname: Méndez-Larramendi
authors.forename: C
authors.initials: C
authors.lastname: Serrano-Verdura
authors.forename: S
authors.initials: S
authors.lastname: Luis-González
mesh_terms: D000328:Adult; D003462:Cuba / Q000453:epidemiology; D004252:DNA Mutational Analysis; D004272:DNA, Mitochondrial / Q000235:genetics; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D008297:Male; D015418:Optic Atrophies, Hereditary / Q000453:epidemiology; D017354:Point Mutation / Q000235:genetics
chemical_list: D004272:DNA, Mitochondrial