Leber hereditary optic neuropathy associated with antiretroviral therapy for human immunodeficiency virus infection

PURPOSE: Antiretroviral therapy has reduced the morbidity and mortality ass ociated with human immunodeficiency virus (HIV) infection. However, side ef fects are increasingly recognized, including a commonly reported toxic mito chondrial myopathy. We report such a case of Leber hereditary optic neuropa thy in a patient with antiretroviral therapy for HIV infection and speculat e on a possible toxic etiologic role in the development of Leber hereditary optic neuropathy by a shared mitochondrial mechanism METHODS: Case Report. Bilateral optic disk abnormalities observed in a 38-y ear-old HIV positive man with a family history of Leber hereditary optic ne uropathy were documented with fundus photography, color vision testing, and visual field testing. Mitochondrial DNA testing was used to confirm the ge netic predisposition to Leber hereditary optic neuropathy. RESULTS: Progressive bilateral optic nerve pallor temporally associated wit h the administration of antiretroviral medication was observed. Diagnostic testing revealed progressive visual field and color vision loss as well as a mitochondrial DNA mutation consistent with Leber hereditary optic neuropa thy. CONCLUSION: Antiretroviral therapy may be associated with the onset of Lebe r hereditary optic neuropathy in genetically predisposed patients. (Am J Op hthalmol 2001;13 1:143-1415. (C) 2001 by Elsevier Science Inc. All rights r eserved.).