**Core Concept**
Leber's hereditary optic neuropathy (LHON) is a rare mitochondrial disorder characterized by the degeneration of the optic nerve, leading to sudden, irreversible vision loss in young adults. The condition is primarily inherited in a maternal lineage, highlighting the importance of mitochondrial DNA in the disease's pathogenesis.

**Why the Correct Answer is Right**
The inheritance pattern of LHON is matrilineal due to the mitochondrial nature of the disease. Mitochondrial DNA is passed down from mother to child, and only mutations in the mitochondrial genome can lead to the development of LHON. This unique inheritance pattern is a result of the fact that only egg cells contribute mitochondria to the fertilized egg, whereas sperm cells do not pass on their mitochondria.

**Why Each Wrong Option is Incorrect**
**Option A:** Autosomal dominant inheritance is incorrect because LHON is not caused by mutations in nuclear DNA, which is inherited in an autosomal dominant pattern.
**Option B:** X-linked recessive inheritance is incorrect because LHON is not linked to the X chromosome, and it affects both males and females equally.
**Option C:** Autosomal recessive inheritance is incorrect because LHON requires only one mutated mitochondrial genome to cause the disease, not two recessive alleles as seen in autosomal recessive conditions.

**Clinical Pearl / High-Yield Fact**
It's essential to remember that LHON is a mitochondrial disorder, and its inheritance pattern is matrilineal. This knowledge can help differentiate LHON from other optic neuropathies with different inheritance patterns.

**Correct Answer:** D. Mitochondrial inheritance.