Leber hereditary optic neuropathy: new and emerging therapies.

Abstract

PURPOSE OF REVIEW:

To review recent therapeutic advances in Leber hereditary optic neuropathy (LHON).

RECENT FINDINGS:

Idebenone, a synthetic analog of ubiquinone (Coenzyme Q10) is an antioxidant and component of the mitochondrial electron transport chain. Since the initial approval of the drug in 2015 in Europe, recent trials have evaluated its role as prolonged treatment in LHON. Gene therapy has recently emerged as a promising alternative for the treatment of LHON. Among several investigations, RESCUE and REVERSE are two phase 3 clinical trials of gene therapy in patients with LHON in early stages. Results in these trials have shown a bilateral visual acuity improvement with unilateral intravitreal injections at 96 weeks and sustained visual improvement after 3 years of treatment. The most recent REFLECT phase 3 clinical trial in LHON has shown significant improvement of vision after bilateral intravitreal injections compared with the group that received unilateral injections.

SUMMARY:

Historically, LHON has been considered an untreatable disease, but recent developments show that new pharmacological and gene therapy approaches may lead to visual recovery. Further studies are needed to support these data.

• Authors: Pamela Davila-Siliezar, Michael Carter, Dan Milea, Andrew G Lee
• Journal: Current opinion in ophthalmology (Curr Opin Ophthalmol) Vol. 33 Issue 6 Pg. 574-578 (Nov 01 2022) ISSN: 1531-7021 [Electronic] United States
• PMID: 36066375 (Publication Type: Journal Article, Review)
• Copyright: Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

Chemical References

• Antioxidants
• DNA, Mitochondrial
• Ubiquinone

Topics

• Antioxidants (therapeutic use)
• Clinical Trials, Phase III as Topic
• DNA, Mitochondrial (genetics)
• Genetic Therapy
• Humans
• Optic Atrophy, Hereditary, Leber (genetics, therapy)
• Ubiquinone (therapeutic use)
• Visual Acuity