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Rafael G. Ortiz, MD; Nancy J. Newman, MD; John M. Shoffner, MD; Allan E. Kaufman, PhD; Deborah A. Koontz, PhD; Douglas C. Wallace, PhD

Arch Ophthalmol. 1993;111(11):1525-1530.

Abstract
Objective
Ophthalmologic and neurologic manifestations of the mitochondrial DNA mutation at position 8993 (MTATP*NARP8993) are reported and compared with previously published reports of patients with the 8993 mutation and other mitochondrial disorders.

Design
Pedigree analysis.

Setting
University referral center.

Patients
Eight subjects from two unrelated pedigrees that were positive for the mitochondrial DNA replacement mutation at nucleotide position 8993 were evaluated ophthalmologically and neurologically.

Results
Retinal abnormalities ranged from mild salt-and-pepper changes to severe retinitis pigmentosa—like changes with maculopathy. Neurologic manifestations were also highly variable and ranged from migraine headaches to severe dementia and Leigh's disease.

Conclusions
The type and extent of retinal pigmentary changes and neurologic findings varied substantially, even among members of the same family. These changes, although not specific for the MTATP*NARP8993 mutation, are highly suggestive of mitochondrial disease.

Author Affiliations
From the Departments of Ophthalmology (Drs Ortiz and Newman), Neurology (Drs Newman, Shoffner, and Wallace), Neurosurgery (Dr Newman), Genetics and Molecular Medicine (Drs Shoffner, Kaufman, Koontz, and Wallace), and Pediatrics (Dr Wallace), Emory University School of Medicine, Atlanta, Ga, and the Department of Ophthalmology, Mayo Clinic, Rochester, Minn (Dr Ortiz). Dr Ortiz is currently in private practice in Miami, Fla.

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