Oxidative Stress in Antibiotic Toxic Optic Neuropathy Mimicking Acute LHON in a Patient with Exacerbation of Cystic Fibrosis

The striking similarity of disc edema without leakage on fluorescein angiography, which is pathognomonic Leber hereditary optic neuropathy (LHON), was present in a patient with cystic fibrosis antibiotic toxic neuropathy. This suggested the common effect oxidative stress retinal ganglion cells inherited mitochondrial and neuropathies. We case advanced chronic treatment who experienced rapid painless bilateral visual decline over course few weeks. At examination, his corrected acuity reduced to 0.3 both eyes, dyschromatopsia central scotoma. appearance fundus resembled typical clinical features acute LHON hyperemic discs tortuous vessels no dye from angiography. Ganglion cell layer loss seen coherence tomography, all findings pointing LHON. Genetic testing did not reveal any LHON-specific mutations. After extended genetic testing, heterozygous variant c.209C>T OPA3 gene chromosome 19, g.46032648G>A, classified as unknown significance, also found. discontinuing antibiotics general improvements health, surprisingly, function completely improved. Later, he received lung transplant that further improved condition, vision remained normal. Excluding LHON, transient our could be mainly due toxicity linezolid ciprofloxacin, have been linked dysfunction hypoxic status. suggest possibility patients may more prone developing neuropathy, especially additional risk factors such therapy, affect function, can perhaps serve model for