Author’s Reply (1)

Thank you for your interest in our article.[1] You raised some questions about our case report; below please notice our answers: 1. As we mentioned in our article the mitochondrial mutation for Leber hereditary optic neuropathy (LHON) was not present in this case and the patient had been labeled as LHON by previous clinicians. Therefore, the diagnosis of LHON was completely presumptive. The ICP that was measured in our case was 18 cmH2O in lateral decubitus position which used to be high before 2016; however, it has been challenged in recent articles that in children it can be up to 26 cmH2O. However, these articles also state that in children you have to interpret the ICP measurement in the context of clinical signs and symptoms, there in effect an lumbar puncture (LP) is not reliable in children. Our patient had some MRI signs of pseudotumor cerebri (PTC) including extensive fluid around the optic nerve and hygroma. Hygromas are normal in older than 60 years olds but not in a child. There are also ample reports of low tension PTCs in the literature.