case_images: PMC6531774_01
case_images: Fundus examination of the right eye at presentation
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case_images: F1
case_images: Bilateral increase of the RNFL thickness at presentation
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case_images: F3
case_images: Fundus examination of the right eye at initiation of treatment with idebenone
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case_images: F5
case_images: Fundus examination at initiation of treatment (Fig. 5,6) revealed plane papilla, with net contour, pale and small excavation at both eyes.
case_images: Normal RNFL thickness, except for the temporal quadrants where the thickness is decreased, at initiation of the treatment with idebenone
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case_images: F7
case_images: RNFL (Fig. 7), except for the temporal quadrants, where the thickness was low. Regarding the GCL-IPL complex (Fig. 8), an emphasis of the thickness decrease compared to the moment of presentation was noticed.
case_images: Severely thinned GCL-IPL complex at initiation of treatment with idebenone
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case_images: F8
case_images: RNFL (Fig. 7), except for the temporal quadrants, where the thickness was low. Regarding the GCL-IPL complex (Fig. 8), an emphasis of the thickness decrease compared to the moment of presentation was noticed.
case_images: Scotoma in the centrocecal area at initiation of treatment with idebenone
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case_images: F9
case_images: Perimetry at initiation of the idebenone treatment (Fig. 9) showed an overall reduction in the sensitivity of the nerve fibers with absolute scotoma in the centrocecal area.
case_images: Fundoscopy at three, six, nine, and twelve months from initiation of the treatment with idebenone
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case_images: F10
case_images: The fundoscopy (Fig. 10) aspect remained the same from the initiation of treatment.
case_images: Progression of atrophy of the optic nerve in all quadrants, except for the nasal fibers that have been spared, at three, six, nine and twelve months from initiation of the treatment with idebenone
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case_images: F11
case_images: At six, nine, and twelve months, we found a stationary look (Fig. 11).
case_images: Severely thinned GCL-IPL complex, at three, six, nine, and twelve months from initiation of the treatment with idebenone
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case_images: F12
case_images: The OCT assessment of the GCL-IPL complex (Fig. 12) revealed a stable appearance.
case_images: Persistence of the centrocecal scotoma and its reduction in periphery, at three, six, nine, and twelve months from the initiation of the treatment with idebenone
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case_images: F13
case_images: As it was observed, there was an improvement at the perimetric evaluation (Fig. 13), the discreet reduction of the scotoma in periphery, but unnoticed by the patient.