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Toxic medications in Leber's hereditary optic neuropathy
Kaitlin Kogachi1, Anna Ter-Zakarian1, Samuel Asanad2
1Doheny Eye Institute, 1355 San Pablo Street, Los Angeles, CA 90033, USA.
Abstract:
Leber's hereditary optic neuropathy (LHON) is a maternally inherited mitochondrial disorder characterized by acute bilateral vision loss. The pathophysiology involves reactive oxygen species (ROS), which can be affected by medications. This article reviews the evidence for medications with demonstrated and theoretical effects on mitochondrial function, specifically in relation to increased ROS production. The data reviewed provides guidance when selecting medications for individuals with LHON mutations (carriers) and are susceptible to conversion to affected. However, as with all medications, the proven benefits of these therapies must be weighed against, in some cases, purely theoretical risks for this unique patient population.
Insights
Leber
Area of Science:
- Mitochondrial medicine
- Neuro-ophthalmology
- Pharmacology
Background:
- Leber's hereditary optic neuropathy (LHON) is a genetic mitochondrial disease causing vision loss.
- Reactive oxygen species (ROS) play a key role in LHON pathophysiology.
- Medications can influence mitochondrial function and ROS levels.
Purpose of the Study:
- To review medications affecting mitochondrial function and ROS in LHON.
- To guide medication selection for LHON carriers at risk of vision loss.
Main Methods:
- Literature review of studies on medications and mitochondrial function.
- Analysis of evidence for demonstrated and theoretical effects on ROS.
- Evaluation of medication risks and benefits in the LHON population.
Main Results:
- Identified medications with potential impact on mitochondrial ROS.
- Provided guidance for managing carriers susceptible to disease conversion.
- Highlighted the need to balance therapeutic benefits against theoretical risks.
Conclusions:
- Medication choice in LHON requires careful consideration of mitochondrial effects.
- Understanding drug-induced ROS modulation is crucial for LHON management.
- Further research is needed to clarify medication safety in LHON patients.