Initial temporal field defect in Leber hereditary optic neuropathy.
OBJECTIVE
To determine the site of the initial field defect in patients with Leber hereditary optic neuropathy (LHON).


METHODS
We studied nine eyes of nine consecutive LHON patients with the 11778 mitochondrial DNA mutation who had no visual loss (four eyes) or only minimal visual loss (five eyes). When unilateral visual loss was observed, Humphrey field analysis (HFA) (HFA 30-2 program and sometimes the HFA 10-2 program) was immediately and repeatedly performed on the better eye.


RESULTS
For the 12 centralmost points in the visual field, a loss of sensitivity (P<0.02) was initially found in the upper temporal field of nine eyes and in the lower temporal field of three eyes. These results indicate that it was possible to detect the initial site of sensitivity loss in the centralmost temporal test points in all nine cases. The HFA 10-2 program confirmed the sensitivity loss in the temporal field in two cases.


CONCLUSIONS
The centralmost temporal visual field appears to be the most susceptible site in eyes of LHON patients. This suggests that the most susceptible cells during the early stages of LHON are the retinal ganglion cells located in the corresponding region of the retina.
Wakakura
Masato
M
Division of Neuro-Ophthalmology, Inouye Eye Hospital, Tokyo, Japan. wakakura-m@inouye-eye.or.jp.|Inouye Eye Hospital, 4-3 Kanda-Surugadai, Chiyoda-ku, Tokyo, 101-0062, Japan. wakakura-m@inouye-eye.or.jp.
Fujie
Waki
W
Division of Neuro-Ophthalmology, Inouye Eye Hospital, Tokyo, Japan.
Emoto
Yuko
Y
Division of Neuro-Ophthalmology, Inouye Eye Hospital, Tokyo, Japan.
D000293:Adolescent; D000328:Adult; D006801:Humans; D008297:Male; D008875:Middle Aged; D029242:Optic Atrophy, Hereditary, Leber / Q000175:diagnosis*; D012607:Scotoma / Q000175:diagnosis*; D014792:Visual Acuity; D058609:Visual Field Tests; D014794:Visual Fields