title: [Leber's hereditary optic neuropathy in malnutrition: a case report].
abstract: BACKGROUND
  We present a case of Leber's hereditary optic neuropathy (LHON) manifested by malnutrition, tobacco and alcohol abuse.
  
  
  METHODS
  We report on a 36-year-old patient with alcohol and tobacco abuse for years. 5 months before manifestation of LHON, the alcohol abuse was stopped. Because of congenital cataract the reduction in visual acuity, which occurred after alcohol consumption was stopped, was first misinterpreted. Findings at first exam: visual acuity right eye 0.2, left eye 0.05, temporal optic disc pallor left > right, vitamin B12 and folic acid at the lower level. Molecular genetic analysis: LHON mtDNA 11 778 mutation. Therefore, a pure tobacco-alcohol optic neuropathy could be excluded.
  
  
  RESULTS
  Under high-dose vitamin-B complex substitution the visual acuity did not improve in the next 6 months.
  
  
  CONCLUSIONS
  The cause of the manifestation of the LHON is unknown and multifactorial. In this case the manifestation was caused by malnutrition and tobacco abuse.
authors.affiliation: Institut für Radiologie, Kantonsspital St. Gallen, St. Gallen.
authors.forename: U
authors.initials: U
authors.lastname: Lachmund
authors.forename: D S
authors.initials: DS
authors.lastname: Mojon
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000150:complications* / Q000175:diagnosis; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000150:complications* / Q000175:diagnosis; D029242:Optic Atrophy, Hereditary, Leber / Q000175:diagnosis* / Q000209:etiology*; D014786:Vision Disorders / Q000175:diagnosis / Q000209:etiology*