Optical Coherence Tomography Angiography vs Fluorescein Angiography in Leber's Hereditary Optic Neuropathy (LHON)

LHON is a mitochondrial disease with sequential, bilateral and dramatic vision loss. The initial clinical presentation of LHON is often subtle with optic disc and peripapillary vascular changes that are frequently missed on funduscopy. In addition, the typical lab work; for optic neuropathies, are usually unremarkable and can lead to challenging delays in diagnosis. Further the genetic marker for; Leber's disease may take quite some time to process. While current treatment may not reverse the dramatic vision loss, it may slow the disease process in hopes of preserving some vision. Given the inherent challenge in diagnosing LHON. Optical Coherence Tomography Angiography (OCT-A) is a novel technique for non-invasive visualization of retinal, optic nerve and choroidal vasculature. While identification of vascular changes in LHON, including peripapillary telangiectasia without leakage, can be made with Fluorescein Angiography (FA), the recent availability of OCT-A offers a rapid diagnostic technique that can aid clinicians to be cognizant of the possibility that the patient may harbor LHON.