Late onset of Leber's hereditary optic neuropathy in HIV infection

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Abstract
A 59 year old white man was admitted to our outpatient department in July 1997 with acute onset of vision loss in his left eye within the previous 2 weeks. The patient had been diagnosed with HIV infection in 1991. No opportunistic infections defining AIDS had been present so far. Antiretroviral therapy consisted of zidovudine since June 1991 as well as additional indinavir and nevirapine since January 1997. Best corrected visual acuity was right eye 20/20 and left eye 6/20. Further ophthalmic examination revealed a left afferent pupillary defect and an absolute central scotoma in the left eye. Indocyanine green angiography and fluorescein angiography disclosed a slight oedema of the optic disc without leakage. Visual evoked potentials (VEP) of the left eye showed reduced central amplitudes and prolonged latencies. Ophthalmic examination of the right eye at the time of presentation was normal.

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