METAP1D (c.41G > T), ACACB (c.1029del), ME3 (c.972G > C), NIPSNAP3B (c.280G > C, c.476C > G), and NSUN4 (c.4A > G) seem to be involved in the penetrance of LHON. Here, METAP1D is linked to Leber hereditary optic neuropathy.