“…Retinoscopy has provided evidence for ganglion cell degeneration as a possible pathophysiological mechanism to explain the visual dysfunction symptoms observed in several metabolic neuropathies, such as heredodegenerative diseases (e.g., Leber's hereditary optic neuropathy), nutritional deficiencies (e.g., vitamin B9 [folic acid] and vitamin B12 [cobalamin] deficiencies), and toxic conditions (e.g., those associated with exposure to ethambutol, cyanide, ethanol, and tobacco, among many other toxicants; Plant & Perry, 1990; Sadun et al, 1994; de Lima et al, 2006; Orssaud, Roche, & Dufier, 2007). Impairment of mitochondrial function attributable to genetic mutations, endogenous toxicity secondary to vitamin deficiency, or toxic exposure to exogenous agents has been considered a common pathway leading to neuronal degeneration in these diseases (Sadum, 2002a, b; Carelli, Ross-Cisneros, & Sadun, 2004; Sadun & Carelli, 2006; Orssau et al, 2007).…”