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Claron D. Alldredge, MD; Christopher R. Schlieve; Neil R. Miller, MD; Leonard A. Levin, MD, PhD

Arch Ophthalmol. 2003;121:1582-1585.

Objectives  To describe the optic neuropathy associated with the genetic defect in Friedreich ataxia and suggest a pathophysiologic mechanism.

Methods  An experimental model of retinal ganglion cell death in the presence of metal chelation was used to test a hypothetical mechanism for the optic neuropathy of Friedreich ataxia.

Results  Study of cultured rat retinal ganglion cells suggests that abnormal regulation of intracellular iron levels could increase sensitivity to reactive oxygen species and lead to cell death in these metabolically active tissues.

Conclusion  We hypothesize that decreased expression of frataxin, the mutated gene in Friedreich ataxia, could cause an optic neuropathy by increasing the sensitivity of retinal ganglion cells to oxidative stress.

From the Department of Ophthalmology and Visual Sciences, University of Wisconsin Medical School, Madison (Drs Alldredge and Levin and Mr Schlieve); and the Neuro-ophthalmology Unit, the Wilmer Eye Institute, Johns Hopkins Medical School, Baltimore, Md (Dr Miller). The authors have no relevant financial interest in this article.