We read with interest the article by Fulton and coworkers1 in which the visual course of children with Leber congenital amaurosis was described. We applaud their efforts to measure the grating acuity of these preverbal children using Teller acuity cards, although we have some reservations about the correlation between grating acuities and optotype acuities.2-4 We reported a similar visual course in a cohort of 45 children that we observed longitudinally for a mean of 6.4 years.5 Six of these 45 patients had a documented deterioration of their visual acuity. The most severe visual deterioration occurred in a 15-year-old patient whose visual acuity had decreased from 20/120 to counting fingers at 3 ft OD and from 10/200 to hand movements OS during a 12-year period. All 6 of these patients, who were teenagers or young adults when reexamined, described this visual loss as slow and insidious. Three patients
Lambert SR, Kriss A, Taylor D. Vision in Patients With Leber Congenital Amaurosis. Arch Ophthalmol. 1997;115(2):293–294. doi:10.1001/archopht.1997.01100150295035
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