If you are a person living or coexisting (friends, partners, relatives, associates) with Leber’s Hereditary Optic Neuropathy – LHON, or if you want to be a part of our network, make your registration! We want to know you a little more!
01. Name or Preferred Name
06. Date of birth
MaleFemaleTrans (or non-binary)
08. Are you a person living or coexisting with Leber’s Hereditary Optic Neuropathy – LHON?
09. If not, what is your relationship with Leber’s Hereditary Optic Neuropathy – LHON?
10. If yes, which genetic variation?
---Without diagnosisG 11778 mutation14484 mutation3460 mutationOthersI don't have Lhon
11. Do you have LHON Plus symptoms?
---YesNoI don't know
12. If yes, which ones?
13. Are you on any treatment?
14. Which medicine do you use?
---idebenoneidebenone (Raxone)otherI do not take any medicine
15. In case you use another medicine, specify which one:
16. Do you have a medical follow-up with a neuro-ophthalmologist?
17. If you have a medical follow-up, indicate in which city:
+55 (11) 99547-3306