Cuban Epidemic Optic Neuropathy: A Mitochondrial Insufficency?

In January of 1992, in a remote western province of Cuba (Pinar del Rio), men between the ages of 25 and 64 began presenting with visual and neurological complaints . Most patients suffered a sub-acute loss of vision in both eyes. Additionally, approximately 20% of the patients complained ofparesthesias or dysesthesias.' Additionally, many patients had considerable weight loss as well as fatigue and polyuria. While the ftrst few cases were diagnosed as tobacco/alcohol amblyopia, by mid 1992 the number of cases had reached epidemic proportions.' When coxsackie virus grew out from most samples of cerebral spinal fluid (CSF), a viral hypothesis came into favor.' By the end of 1992, nearly 1000 cases bad been diagnosed, still mainly from the rural western area of Cuba.