Klin Monbl Augenheilkd 2017; 234(04): 584-587
DOI: 10.1055/s-0042-119564
Der interessante Fall
Georg Thieme Verlag KG Stuttgart · New York

Leberʼs Hereditary Optic Neuropathy, Normal Tension Glaucoma, and Flammer Syndrome: Long Term Follow-up of a Patient

Lebersche hereditäre Optikusneuropathie, Normaldruckglaukom und Flammer-Syndrom – eine langzeitige Beobachtung eines Patienten
K. Konieczka
1   Department of Ophthalmology, University of Basel, Basel, Switzerland (Chairman: Prof. Dr. Hendrik Scholl)
,
J. Flammer
1   Department of Ophthalmology, University of Basel, Basel, Switzerland (Chairman: Prof. Dr. Hendrik Scholl)
,
J. Sternbuch
2   Private Practice, Zurich, Switzerland
,
T. Binggeli
1   Department of Ophthalmology, University of Basel, Basel, Switzerland (Chairman: Prof. Dr. Hendrik Scholl)
,
S. Fraenkl
3   Department of Ophthalmology, University of Bern, Bern, Switzerland (Chairman: Prof. Dr. Dr. Sebastian Wolf)
› Author Affiliations
Further Information

Publication History

Publication Date:
31 January 2017 (online)

Background

In our clinic, we observed a patient with the risk constellation of a mitochondrial DNA mutation (G7444A-mutation) combined with Flammer syndrome (FS) [1], [2], [3], who developed a classical phenotype of a Leberʼs hereditary optic neuropathy (LHON) in one eye, subsequently chronic progressive normal tension glaucoma (NTG) in the other eye, and finally, optic nerve compartment syndrome (ONCS) [4] and a marked increase in the retinal venous pressure (RVP) [5] on both sides. This stimulated the discussion of whether these individual clinical and laboratory findings were an accidental concurrence, or whether they were dependent on each other.

Abbreviations

FS: Flammer syndrome
LHON: Leberʼs hereditary optic neuropathy
NTG: normal tension glaucoma
ONCS: optic nerve compartment syndrome
ONH: optic nerve head
PVD: primary vascular dysregulation
RVP: retinal venous pressure

 
  • References

  • 1 Konieczka K, Ritch R, Traverso CE. et al. Flammer syndrome. EPMA J 2014; 5: 11
  • 2 Flammer J, Konieczka K, Flammer AJ. The primary vascular dysregulation syndrome: implications for eye diseases. EPMA J 2013; 4: 14
  • 3 Flammer J, Konieczka K, Bruno RM. et al. The eye and the heart. Eur Heart J 2013; 34: 1270-1278
  • 4 Killer HE. Compartment syndromes of the optic nerve and open-angle glaucoma. J Glaucoma 2013; 22 (Suppl. 05) S19-S20
  • 5 Flammer J, Konieczka K. Retinal venous pressure: the role of endothelin. EPMA J 2015; 6: 21
  • 6 Konieczka K, Todorova MG, Bojinova RI. et al. Unexpected effect of calcium channel blockers on the optic nerve compartment syndrome. Klin Monatsbl Augenheilkd 2016; 233: 387-390
  • 7 Spruijt L, Kolbach DN, de Coo RF. et al. Influence of mutation type on clinical expression of Leber hereditary optic neuropathy. Am J Ophthalmol 2006; 141: 676-682
  • 8 Newman NJ. Hereditary optic neuropathies: from the mitochondria to the optic nerve. Am J Ophthalmol 2005; 140: 517-523
  • 9 Yen MY, Wang AG, Wei YH. Leberʼs hereditary optic neuropathy: a multifactorial disease. Prog Retin Eye Res 2006; 25: 381-396
  • 10 Eichhorn-Mulligan K, Cestari DM. The genetics of Leber hereditary optic neuropathy – prototype of an inherited optic neuropathy with mitochondrial dysfunction. Semin Ophthalmol 2008; 23: 27-37
  • 11 Brown MD, Yang CC, Trounce I. et al. A mitochondrial DNA variant, identified in Leber hereditary optic neuropathy patients, which extends the amino acid sequence of cytochrome C oxidase subunit I. Am J Hum Genet 1992; 51: 378-385
  • 12 Jin L, Yang A, Zhu Y. et al. Mitochondrial tRNASer(UCN) gene is the hot spot for mutations associated with aminoglycoside-induced and non-syndromic hearing loss. Biochem Biophys Res Commun 2007; 361: 133-139
  • 13 Lopez Sanchez MI, Crowston JG, Mackey DA. et al. Emerging mitochondrial therapeutic targets in optic neuropathies. Pharmacol Ther 2016; 165: 132-152
  • 14 Tsao K, Aitken PA, Johns DR. Smoking as an aetiological factor in a pedigree with Leberʼs hereditary optic neuropathy. Br J Ophthalmol 1999; 83: 577-581
  • 15 Mashima Y, Kimura I, Yamamoto Y. et al. Optic disc excavation in the atrophic stage of Leberʼs hereditary optic neuropathy: comparison with normal tension glaucoma. Graefes Arch Clin Exp Ophthalmol 2003; 241: 75-80