Assessing the effect of idebenone in LHON by silent-MT 7T-MRI of the optic nerve requires appropriate study designs

Josef Finsterer, MD, PhD*

Assessing the effect of idebenone in LHON by silent-MT 7T-MRI of the optic nerve requires appropriate study designs

Josef Finsterer, MD, PhD*

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Josef Finsterer, MD, PhD*, “Assessing the effect of idebenone in LHON by silent-MT 7T-MRI of the optic nerve requires appropriate study designs”, ijmhs, vol. 10, no. 06, pp. 918–919, Jun. 2020.

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Abstract

With interest we read the article by Grochowski et al.
about an investigation of the optic nerves in 6 patients
with Leber’s hereditary optic neuropathy (LHON) receiving
idebenone and 9 LHON patients not receiving idebenone by
means of a Zero Echo Time (ZET) 7T MRI sequence with
an Adiabatic Spectral Inversion Recovery (ASPIR) fat suppression
pulse (silent-MT 7T-MRI) [1]. It was concluded
that the technique confirms known pathology of the optic
nerve in LHON [1]. We have the following comments and
concerns.
We disagree with the notion that ‘LHON is a disorder of
the optic nerve. LHON is pirmarely a disorder of the retinal
ganglion cells (RGCs), which is why it can be diagnosed by
the ophthalmologist. Secondarily, LHON affects dendrites
and axons of RGCs resulting in asymmetric optic atrophy.
There are no striking conclusions from this study. The
only results were that the silent-MT at 7T depicts the optic
nerve with high quality and artefact-free, that quantitative
measures of the optic nerve can be obtained, and that
LHON optic nerves showed focal hyperintensities.
The authors do not differentiate b etween L HON and
LHON plus [2]. LHON exclusively affects t he retina,
whereas LHON plus is characterised by multiorgan involvement,
affecting i n p articular t he e yes b ut a lso t he brain,
endocrine organs, bone marrow, arteries, kidneys, peripheral
nerves, and the heart [2]. We should know how many
of the included patients had LHON and how many LHON
plus. This is crucial as it may determine the outcome of
these patients [3].

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Issue Vol. 10 No. 06 (2020): Innovative Journal of Medical and Health Science
Section Research Articles

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Assessing the effect of idebenone in LHON by silent-MT 7T-MRI of the optic nerve requires appropriate study designs

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