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Visual acuity (VA), visual fields, optical coherence tomography (OCT), and fundus images were assessed. Vessel tortuosity was qualitatively graded. Idebenone treatment history was obtained from the registry.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fifty-nine eyes were analysed. Six eyes exhibited no to mild visual impairment, of which four belonged to individuals with age at onset &lt;15 years. This group demonstrated significantly better VA (0.7\u2009\u00b1\u20090.8 vs 1.5\u2009\u00b1\u20090.5 and 1.3\u2009\u00b1\u20090.5 logMAR), higher visual field score (76.9\u2009\u00b1\u200925.8 vs 47.1\u2009\u00b1\u200927.7 and 29.7\u2009\u00b1\u200921.1%), and thicker average GCC (72.3\u2009\u00b1\u200930.8 vs 49.9\u2009\u00b1\u200911.6 and 48.7\u2009\u00b1\u20094.5\u2009\u00b5m) compared with older-onset groups. Moderate to severe tortuosity was more prevalent in the youngest-onset group. Among individuals with onset \u226515 to \u226435 years, GCC thickness correlated with visual function. Overall, 68% received Idebenone and majority of them were treated within six months of onset (68%), but no significant outcome differences were observed between the treated and untreated subjects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>LHON onset before 15 years of age is associated with better preserved retinal structure and visual function in the chronic stage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1038\/s41433-026-04866-7","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T10:07:35Z","timestamp":1790158055000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Functional and structural analysis in relation to age at onset of Leber hereditary optic neuropathy: a Swedish cohort"],"prefix":"10.1038","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-7332-7744","authenticated-orcid":false,"given":"Johan","family":"Hedstr\u00f6m","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Nilsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Fagerstr\u00f6m","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Engvall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6194-8397","authenticated-orcid":false,"given":"Pete A.","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2155-7030","authenticated-orcid":false,"given":"Abinaya Priya","family":"Venkataraman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"4866_CR1","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1093\/brain\/awac395BRAIN2023","volume":"146","author":"A Rocatcher","year":"2022","unstructured":"Rocatcher A, Desquiret-Dumas V, Charif M, Ferr\u00e9 M, Gohier P, Mirebeau-Prunier D, et al. 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