Fig. 1From: Sulthiame impairs mitochondrial function in vitro and may trigger onset of visual loss in Leber hereditary optic neuropathyTimeline of STM dosage and visual acuity in two unrelated juvenile patients with LHON. a Patient #1 already had visual impairment with visual acuity of 0.5 before start of STM treatment. Shortly after initiation of antiepileptic medication with STM 3.3 mg/kg BW per day the patient complained of further visual impairment with visual acuity of 0.2 as assessed 3 weeks later. Due to persistently recurring seizures STM dosage was increased to 6.6 mg/kg BW per day. A few days later (9 weeks after start of STM) the girl complained marked further visual decline with visual acuity of 0.02. Hereupon STM was stopped. Under treatment with idebenone a slight recovery of visual acuity was observed in the following months. b Patient #2 had no history of previous visual impairment. Antiepileptic treatment with STM was started with 4.2 mg/kg BW per day. Due to persistently recurring seizures the dosage was increased in two steps to 8.7 mg/kg BW per day after 4 months. The next day the boy complained marked visual loss on his right eye, visual acuity was 0.1 in the subsequent ophthalmologic examination. Thus STM was stopped and a treatment with idebenone was initiated. In the further course a complete recovery of visual acuity could be observedBack to article page