Partial atrophy of the eye. A ruthless and hard-to-treat disease: how does descending optic nerve atrophy manifest itself? Hereditary forms of AD

Optic nerve atrophy is a disease in which there is a decrease in vision, sometimes to its complete loss. This happens when the nerve fibers that carry information about what a person sees from the retina of the eye to the visual part of the brain die partially or completely. Such a pathology can occur due to many reasons, because a person can encounter it at any age.

Important! Timely detection and treatment of the disease, if the death of the nerve is partial, helps to stop the loss of visual function and restore it. If the nerve has atrophied completely, then vision will not be restored.

The optic nerve is an afferent nerve fiber that runs from the retina to the occipital visual region of the brain. Thanks to this nerve, information about the picture seen by a person is read from the retina, and transmitted to the visual department, and in it it is already being transformed into a familiar image. When atrophy occurs, nerve fibers begin to die off and are replaced by connective tissue that looks like scar tissue. In this condition, the functioning of the capillaries that feed the nerve stops.

How is the disease classified?

According to the time of occurrence, there is congenital and acquired atrophy of the optic nerve. By localization, the pathology can be:

1. ascending - the layer of nerve fibers located on the retina of the eye is affected, and the lesion itself is sent to the brain;
2. descending - the visual part of the brain is affected, and the lesion is directed to the disk on the retina.

Depending on the degree of the lesion, atrophy can be:

• initial - only some fibers are affected;
• partial - the diameter of the nerve is affected;
• incomplete - the lesion is common, but vision is not completely lost;
• complete - the optic nerve dies, leading to a complete loss of visual function.

With a unilateral disease, one nerve is damaged, as a result of which it begins to see poorly in one eye. When the nerves of the two eyes are affected, they speak of bilateral atrophy. According to the stability of the visual function, the pathology can be stationary, in which visual acuity falls and then stays at the same level, and progressive, when vision becomes worse.

Why can the optic nerve atrophy

The causes of optic nerve atrophy are varied. The congenital form of the disease in children occurs due to genetic pathologies such as Leber's disease. In this case, partial atrophy of the optic nerve most often occurs. The acquired form of pathology occurs due to various diseases of a systemic and ophthalmic nature. Nerve death can occur due to:

• compression of the vessels feeding the nerve or the nerve itself by a neoplasm in the skull;
• myopia;
• atherosclerosis leading to plaques in the vessels;
• thrombosis of nerve vessels; v
• inflammation of the vascular walls during syphilis or vasculitis;
• violations of the structure of blood vessels due to diabetes mellitus or high blood pressure;
• eye injury;
• intoxication of the body during respiratory viral infections, with the use of large doses of alcohol, drugs or due to excessive smoking.

The ascending form of the disease occurs with eye diseases such as glaucoma and myopia. Causes of descending optic nerve atrophy:

1. retrobulbar neuritis;
2. traumatic damage to the place where the optic nerves cross;
3. neoplasm in the pituitary gland of the brain.

Unilateral disease occurs due to diseases of the eyes or orbits, as well as from the initial stage of cranial diseases. Both eyes can immediately suffer from atrophy due to:

• intoxications;
• syphilis;
• neoplasms in the skull;
• poor blood circulation in the vessels of the nerve during atherosclerosis, diabetes, hypertension.

What is the clinical picture of the disease

Symptoms of optic nerve atrophy depend on the form of the disease. When this disease occurs, vision cannot be corrected with glasses. The most basic sign is a decrease in visual acuity. The second symptom is a change in the fields of visual function. On this basis, the doctor can understand how deeply the lesion has arisen.

The patient develops "tunnel vision", that is, a person sees as he would see if he put a tube to his eye. Peripheral (lateral) vision is lost and the patient sees only those objects that are directly in front of him. In most cases, such vision is accompanied by scotomas - dark spots in any part of the visual field. Later, a disorder of color perception begins, the patient first ceases to distinguish between green, then red.

With damage to nerve fibers that are concentrated as close as possible to the retina or directly in it, dark spots appear in the center of the visible image. With a deeper lesion, half of the image from the side of the nose or temple may disappear, depending on which side the lesion occurred. With secondary atrophy that has arisen due to any ophthalmic disease, the following symptoms occur:

• the veins of the eyes dilate;
• the vessels constrict;
• the boundaries of the optic nerve area become smoothed;
• retinal disc becomes pale.

Important! If even a slight clouding appears in the eye (or both eyes), it is necessary to visit an ophthalmologist as soon as possible. Only by detecting the disease in time, it is possible to stop it at the stage of partial atrophy and restore vision, preventing complete atrophy.

What are the features of pathology in children

With a congenital form of the disease, it can be determined that the baby's pupils react poorly to light. When a child grows up, parents may notice that he does not react to an object brought to him from a certain side.

Important! A child under two or three years of age may not report that he or she has poor vision, and older children who have a congenital problem may not be aware that they can see differently. That is why it is necessary that the child be examined by an ophthalmologist annually, even if there are no symptoms visible to the parent.

Parents should take the child to the doctor if he rubs his eyes or unconsciously tilts his head to one side, trying to see something. The forced tilt of the head to some extent compensates for the function of the affected nerve and slightly sharpens vision. The main clinical picture of optic nerve atrophy in a child is the same as in an adult.

If diagnosed and treated in a timely manner, provided that the disease is not genetic, during which the nerve fibers are completely replaced by fibrous tissue even during fetal development, then the prognosis for the restoration of the optic nerve in children is more favorable than in adult patients.

How the disease is diagnosed

Diagnosis of atrophy of the optic nerve is carried out by an ophthalmologist, and primarily includes an examination of the fundus and the determination of visual fields using computer peripetry. It also determines which colors the patient distinguishes. Instrumental methods of diagnosis include:

• x-ray of the cranium;
• Magnetic resonance imaging;
• angiography of the vessels of the eye;
• video ophthalmological examination;
• Ultrasound of the vessels of the head.

Thanks to these studies, it is possible not only to identify the death of the optic nerve, but also to understand why it happened. It may also be necessary to consult related specialists.

How is optic nerve atrophy treated?

How to treat atrophy of the optic nerve should be decided by the doctor based on the studies. It should be noted right away that the treatment of this disease is very difficult, because nerve tissues regenerate very poorly. It is necessary to carry out complex systematic therapy, which should take into account the cause of the pathology, its prescription, the age of the patient, and his general condition. If some process inside the skull led to the death of the nerve (for example, a tumor or inflammation), then the treatment should be started by a neurosurgeon and a neuropathologist.

Medication treatment

With the help of drugs, you can increase blood circulation and trophism of the nerve, as well as stimulate the vital activity of healthy nerve fibers. Medical treatment includes taking:

• vasodilators - No-Shpy and Dibazol;
• vitamin B;
• biogenic stimulants, for example, aloe extract;
• drugs that improve microcirculation, such as Eufillin and Trental;
• steroidal anti-inflammatory drugs - Hydrocortisone and Dexamethasone;
• antibacterial drugs, if atrophy has an infectious-bacterial pathogenesis.

In addition, physical therapy procedures to stimulate the optic nerve, such as laser stimulation, magnetic therapy, or electrophoresis, may be required.

Microsurgical treatment is aimed at eliminating the compression of the nerve, as well as at increasing the diameter of the vessels that feed it. Conditions can also be created in which new vessels can grow. Surgery can only help with partial atrophy, if the nerves die off completely, then even through surgery it is impossible to restore visual function.

Treatment with folk remedies

Treatment of optic nerve atrophy with folk remedies is permissible only at the initial stage of the disease, but it is not aimed at improving vision, but at eliminating the root cause of the disease.

Important! Self-medication without prior medical consultation can only aggravate the situation and lead to irreversible consequences.

If the disease is caused by high blood pressure, then plants with antihypertensive properties are used in therapy:

• astragalus woolly-flowered;
• small periwinkle;
• hawthorn (flowers and fruits);
• chokeberry;
• Baikal skullcap (root);
• Dahurian black cohosh;
• large-flowered magnolia (leaves);
• drier dryer.

Blueberries are useful for vision, they contain many vitamins, as well as anthocyanosides, which have a positive effect on the visual apparatus. For treatment, you need to mix one kilogram of fresh berries with one and a half kilograms of sugar and refrigerate. This mixture is taken in half a glass for a month. The course must be repeated twice a year, which will benefit even with good vision.

If dystrophic processes occur in the retina of the eye, especially those occurring against the background of low blood pressure, then tinctures will be useful, for the preparation of which are used:

1. leaves of Chinese magnolia vine;
2. lure roots;
3. leuzea;
4. ginseng;
5. eleutherococcus;
6. sea ​​buckthorn (fruits and pollen).

If incomplete necrosis of the nerves occurs or senile degenerative changes occur in the eyes, then anti-sclerotic plants should be taken:

1. orange;
2. cherry;
3. hawthorn;
4. cabbage;
5. corn;
6. seaweed;
7. dandelion;
8. chokeberry;
9. garlic and onion.

Useful properties have carrots (contains a lot of carotene) and beets (rich in zinc)

What is the prognosis for optic nerve atrophy and its prevention

When diagnosing and starting therapy at an early stage of development, it is possible to maintain and even slightly increase visual acuity, as well as expand its fields. No treatment can fully restore visual function. If the disease progresses and there is no treatment, then this leads to disability due to complete blindness.

In order to prevent the necrosis of nerve fibers, it is necessary to undergo timely treatment of ophthalmic diseases, as well as diseases of the endocrine, neurological, infectious and rheumatological nature. Very important in prevention is the prevention of intoxication damage to the body.

Optic nerve atrophy is the destruction of the nerve fibers that perceive visual stimuli through the retina and send them to the brain. The destruction of fibers can be not only complete, but also partial. With this pathology, vision is reduced or lost completely. The observed fields may narrow, color perception may be disturbed, the optic disk of the optic disc may turn pale.

The ophthalmologist makes such a diagnosis after examination with an ophthalmoscope, color perception testing, perimeter testing, craniography, visual acuity testing, CT, brain, eye scanning with ultrasound, etc.

Treatment of the disease will be aimed at eliminating the cause that led to such serious consequences. Restoration of the optic nerve is a complex process that requires a competent approach. With some types of pathology, this is not possible. Especially dangerous is atrophy of the optic nerves of both eyes.

What is atrophy

Diseases of the optic nerve are diagnosed by ophthalmologists less often (1-1.5%). Only a fifth of them eventually lead to complete blindness.

The essence of the problem is that during the destruction of the optic nerve, the axons of the cells that form the retina are destroyed. The cells themselves are deformed, and the nerve becomes thinner, its capillaries are destroyed. More often than not, adults suffer from this disease. In infants, it is caused by infectious diseases, hydrocephalus, hereditary syndromes, and autoimmune diseases.

The process itself can develop in different ways, it can be quite fast or relatively slow. Often there is a blockage of blood vessels, which has an extremely negative effect on the condition of the nerve tissues. A person loses visual acuity, and this happens quite abruptly. If it is possible to achieve an improvement in the blood supply to the nerve tissues, they cease to be destroyed and even partially restored.

Please note that such negative factors can lead to atrophy: severe alcohol poisoning, damage to the body by viral infections, eye diseases, hereditary predisposition, severe profuse bleeding, hypertension, atherosclerosis, tumors.

Atrophy is the result of many diseases in which swelling, inflammation, compression, damage to blood vessels or nerve fibers of the eyes appear. You can restore vision if you immediately start treatment, until the atrophy itself has completely affected the nerve.

Let's understand the reasons

The causes of optic nerve atrophy are quite diverse. The most common are tumors, neurological pathologies, infections, diseases of large and small vessels.

All factors are divided into several groups:

1. diseases of the eyes themselves;
2. dysfunction of the central nervous system;
3. intoxication;
4. injury;
5. general diseases, etc.

Often, atrophy can be caused by ophthalmic causes:

1. glaucoma;
2. occlusion of the artery that feeds the retina;
3. death of retinal tissue;
4. uveitis;
5. myopia;
6. neuritis, etc.

A tumor or disease of the orbit can damage the nerve.

If we talk about diseases of the central nervous system, then pituitary tumors, inflammatory diseases (meningitis, encephalitis, arachnoiditis, abscess), multiple sclerosis, (head injuries), and injury to the optic nerve when the face is damaged are in the lead.

Even long-term hypertension, beriberi, starvation, intoxication can cause atrophy. Among the latter, poisoning with technical alcohol, chlorophos, nicotine, etc. is very dangerous. Sudden blood loss, anemia, diabetes can also adversely affect the condition of the optic nerve fibers.

Serious damage to the body by infection can lead to atrophy. Dangerous and toxocariasis and toxoplasmosis.

Atrophy is also congenital, and in an infant it may not be detected immediately. This reduces his chances of restoring visual function. Often this disease appears in premature babies, it can also be inherited from parents. A newborn cannot say that he sees poorly or that something hurts him, therefore parents should carefully monitor the behavior of the crumbs. At the first suspicion, you should consult a doctor.

Acrocephaly, macrocephaly, microcephaly, dysostosis, hereditary syndromes lead to the congenital form. In a fifth of cases of visual atrophy, its causes cannot be determined at all.

Classification

Optic nerve atrophy can be both acquired and hereditary. In the latter case, deafness often joins. It can be relatively light or heavy.

Acquired ailment can be primary, secondary, glaucomatous. In primary atrophy, the peripheral neurons of the optic nerve are compressed. The boundaries of the ONH remain clear.

With atrophy of the secondary optic disc, edematous, a pathological process occurs in the retina or nerve. Over time, nerve fibers are replaced by neuroglia, which causes the diameter of the optic disc to grow, and its boundaries become blurred.

With glaucomatous optic atrophy, due to high intraocular pressure, the cribriform plate of the sclera collapses and dies.

The ophthalmologist can determine, as the color of the optic disc changes, at what stage the pathological process is (initial stage, partial, complete atrophy). At the initial stage, the optic disc becomes slightly pale, the nerve itself retains the correct color. If the atrophy is partial, only part of the nerve (segment) turns pale. At full - the entire disk turns pale and thinner, the vessels of the fundus narrow, can be damaged.

According to the location, atrophy is distinguished:

• ascending and descending;
• unilateral and bilateral.

As it progresses, it happens:

• stationary;
• progressive.

Symptoms

Symptoms may vary in their manifestation. It all depends on the root cause of the disease. The main symptom is reduced vision, and this process cannot be corrected either with lenses or with glasses. How quickly vision is lost depends on the type of atrophy, its cause. If it is a progressive type, then vision may decrease in just a few days. The result can be complete blindness.

With partial atrophy of the optic nerves, pathological changes reach a certain limit and then stop in development. A person loses sight partially.

With atrophy, visual function is impaired. Fields of vision may narrow (peripheral vision disappears), tunnel vision may appear, the patient may perceive colors inadequately, dark spots may appear before the eyes. On the affected side, the pupil stops responding to light.

The so-called blind or dark spots are a typical manifestation of optic nerve atrophy. Often, patients complain that they see dark spots before their eyes.

Secondary atrophy can manifest itself in different ways. One of the common causes of the secondary process is tabes. This is a late manifestation of syphilis, in which many organs and systems are affected. Also, the disease can manifest itself due to paralysis, which progresses. Fields of vision begin to narrow, visual function suffers greatly.

If the cause is sclerosis of the carotid artery, the patient develops hemianopsia - blindness of half of the visual field. After profuse bleeding, with unfavorable development, blindness can also occur. It is characterized by the fact that the lower fields of vision fall out.

To find out exactly whether it is atrophy, you need to undergo a complete examination by an ophthalmologist.

Atrophy in children

If there are suspicions that the child has a visual impairment, he must be examined by an ophthalmologist. It is extremely important to identify such a lesion at an early stage, then the prognosis will be as favorable as possible.

The development of atrophy in children is often associated with a hereditary factor. It is also caused by intoxication, inflammation of the brain tissues, their swelling, damage to the eyeball, pathology of pregnancy, problems with the National Assembly, tumors, hydrocephalus, injuries, etc.

Manifestation in children

It is difficult to identify such a serious pathology in a child, especially when it comes to infants. All hope for the vigilance of doctors. They are able to identify the pathology in the first days of the child's life during the examination. Be sure the doctor must examine the pupils of the crumbs, determine how they react to light, how the eyes follow the movement of the object.

If the pupil does not react to light, is dilated, and the child does not follow the object, this is considered a bone sign of the presence of a pathological process.

It is important for parents to respond in time to the onset of symptoms and immediately show the child to an ophthalmologist. Untimely treatment or its absence can lead to partial or complete blindness.

congenital atrophy

This form is the most difficult to treat. It accompanies many congenital pathological syndromes.

If atrophy is detected, the doctor must establish its degree, cause, find out how damaged the nerve fiber is.

If we talk about the diagnosis of children, then it is complicated by the fact that the child cannot tell about his subjective sensation or visual impairment. This is where preventive care comes into play. They will help to identify the pathology at an early stage.

It is also important that the parents themselves carefully monitor the state of the child. It is they who can notice that the child began to behave unusually, stopped responding to movement around the periphery, looks closely at objects, bumps into them, etc.

Treatment of optic nerve atrophy in children is not much different from getting rid of pathology in adults. The drugs and their doses can only differ. In some cases, emergency surgery is indicated. Among drugs, it is important to use those that improve blood circulation, constrict blood vessels. Along with them, vitamins, drugs to stimulate metabolic processes are prescribed.

Diagnostics

At first glance, this diagnosis leaves no chance of restoring vision, but this is a delusion. In four cases out of five, vision can be restored at least partially. During the diagnosis, the ophthalmologist must definitely find out what concomitant diseases the patient has, whether he is taking medication, whether he can come into contact with chemicals, whether he has bad habits. All this can cause damage to the optic nerve.

Visually, the doctor can determine whether the patient's eyeball is protruding, whether it is mobile (the patient must look down, up, left, right), how correctly the pupils react, and whether there is a corneal reflex. He must check visual acuity, color perception, perimeter.

The main diagnostic method is ophthalmoscopy. It helps to examine the optic nerve disc in detail, to find out if it has turned pale, if its contours and color are blurred. The number of small vessels on the disk may decrease, the caliber of the arteries on the retina may narrow, and the veins may change. To confirm or refute the diagnosis, tomography can additionally be used.

With EVP (electrophysiological examination), the doctor may detect increased sensitivity of the optic nerve. If we are talking about glaucomatous form, the doctor can use a tonometer.

Plain radiography is used to study the orbit. Doppler ultrasound is used to study blood flow. Often, additional consultations with a neurologist, x-ray of the skull, MRI, CT scan of the brain are required. If a neoplasm of the brain, increased intracranial pressure was detected, a consultation with a neurosurgeon will also be needed.

Consultation with a rheumatologist is required for systemic vasculitis. With tumors of the orbit, the help of an ophthalmo-oncologist is needed. If damage to large blood vessels is detected, you need to contact a vascular surgeon, an ophthalmologist. If there is a suspicion that an infection is present, PCR and ELISA tests are prescribed.

It is important to exclude amblyopia, peripheral cataract, as their symptoms are very similar to signs of atrophy.

Treatment

If atrophy of the optic nerve is detected, the treatment rests solely with the ophthalmologist. At his disposal are many modern methods of treatment and quite effective drugs. The main thing is not to get rid of the atrophy itself, as a consequence, but to fight its cause.

Attempts to treat such a serious pathology at home with the help of dubious folk remedies look sad. The patient thus loses precious time and chances for recovery. It is impossible to get rid of optic nerve atrophy if its cause is not eliminated!

Most often, optic nerve atrophy is not an independent disease, but a consequence of the development of some pathological process. Diseases, including infectious ones, can lead to atrophy. Infections quickly damage the optic nerve. Injuries, dysfunction of large vessels, genetic abnormalities, autoimmune lesions, etc. are also dangerous.

If it is precisely established that the cause is a tumor, hypertension, neurosurgical intervention is performed. A successful operation will save the patient's vision, and in some cases life.

With conservative treatment, every effort should be made to preserve the remaining vision as much as possible. The treatment regimen is selected exclusively by an ophthalmologist. Sometimes he works with other specialists.

It is very important to ensure the removal of infiltrate during the inflammatory process, improve blood circulation, the state of blood vessels, and nerve trophism. It is necessary to monitor the indicators of intraocular pressure.

To maximize the effect of the treatment, the doctor may prescribe acupuncture, physiotherapy, magnetotherapy.

If vision falls below 0.01, treatment will not be effective.

Forecast

What will be the prognosis of treatment is affected by how timely it is started and adequately selected. It is extremely important to start it at the earliest stage of development of the pathological process. With a favorable course, vision can not only be restored, but even slightly improved. But it should be understood that it will not be possible to completely restore it.

If the atrophy is progressive, even with very active treatment, it can end in complete blindness.

Prevention

This pathology largely depends on the attitude of a person to his health. Often, the death of the tissues of the optic nerve manifests itself as a complication after the flu, acute respiratory viral infections, it often happens at a late stage in the development of syphilis.

It is extremely important to take care of the timely prevention of such a dangerous pathology. It is necessary to treat eye, endocrine, neurological, infectious diseases, inflammatory processes in the body in time. Since intoxication is very dangerous, poisoning should be avoided, work with chemicals carefully, and do not drink alcoholic beverages.

In the event of profuse bleeding, it is necessary to immediately provide a blood transfusion of the desired group.

It is important to immediately consult an ophthalmologist in case of visual impairment.

So, atrophy of the optic nerve is not so common. The current level of development of medicine, ophthalmology, can quite successfully deal with this disease. With proper treatment, partially visual functions can be restored. It is important not only to choose the right drugs and take them according to the prescribed scheme, but also to eliminate the cause that led to atrophy.

Optic nerve atrophy is a pathological process in which nerve fibers are partially or completely destroyed, replaced by connective tissue. As a result, there is a violation of the functions of the nervous tissue. Most often, atrophy is a complication of some other eye disease.

With the progression of the process, there is a gradual death of neurons, as a result of which the information coming from the retina of the eye enters the brain in a distorted form. With the development of the disease, more and more cells die, eventually the entire nerve trunk is affected.

In this case, it becomes almost impossible to restore visual function. Therefore, treatment should be started at a very early stage, when the first signs of the disease appear.

How is optic nerve atrophy treated, what are the symptoms of this eye disease? We will talk about all this today on this page "Popular about health" with you. But let's start our conversation with the characteristic signs of this pathology:

Symptoms of atrophy of the nerve of the eye

It all starts with a decrease in vision. This process can occur gradually or rapidly, suddenly. It all depends on the location of the nerve lesion, on which segment of the trunk it develops. Depending on the severity of the pathological process, visual impairment is divided into degrees:

Uniform decline. It is characterized by a uniform deterioration in the ability to see objects, to distinguish colors.

Loss of side margins. A person distinguishes well between objects in front of him, but he sees poorly, or does not see at all what is on the side.

Loss of spots. Normal vision is hindered by a spot in front of the eye, which can have different sizes. Within its limits, a person does not see anything, outside of it, vision is normal.

In severe cases of complete atrophy, the ability to see is completely lost.

Treatment of optic nerve atrophy

As we already know, this pathological process is often a complication of another eye disease. Therefore, after the cause is discovered, a complex treatment of the underlying disease is prescribed and measures are taken to prevent further development of optic nerve atrophy.

In the event that the pathological process has just begun and has not yet had time to develop, it is usually possible to cure the nerve and visual functions are restored within a period of two weeks to several months.

If, by the time the treatment begins, atrophy has developed sufficiently, it is completely impossible to cure the optic nerve, since the destroyed nerve fibers cannot be restored in our time. If the damage is partial, rehabilitation is still possible to improve vision. But, with a severe stage of complete damage, it is still impossible to cure atrophy and restore visual functions.

Treatment of eye atrophy consists in the use of drugs, drops, injections (general and local), the action of which is aimed at improving blood circulation in the optic nerve, reducing inflammation, as well as restoring those nerve fibers that have not yet been completely destroyed. Additionally, physiotherapy methods are used.

Drugs used in the treatment:

To improve the blood circulation of the optic nerve, vasodilators are used: Nicotinic acid, No-shpu, Papaverine and Dibazol. Also, patients are prescribed Complamin, Eufillin, Trental. And also Galidor and Sermion. For the same purpose, anticoagulant preparations are used: Ticlid and Heparin.

In order to restore metabolic and regenerative processes in the tissues of the affected nerve, patients are prescribed biogenic stimulants, in particular Vitreous, Peat and aloe preparations. Vitamins, amino acids, enzymes and immunostimulants are also prescribed.

To stop, reduce the inflammatory process, hormone therapy is often used with the help of Prednisolone and Dexamethasone.
In addition, complex treatment includes drugs aimed at normalizing the functioning of the central nervous system: Cerebrolysin, Phezam, as well as Emoxipin, Nootropil and Cavinton.

The doctor prescribes all the above and other medicines individually, after finding out the cause of the pathological process and diagnosing the underlying disease. This takes into account the degree of damage to the optic nerve, the age of the patient, his general condition and the presence of concomitant diseases.

In addition to drugs, physiotherapeutic methods and acupuncture are actively used. Apply methods of magnetic, laser and electrical stimulation of the optic nerve trunk. According to the indications, the patient may be recommended surgical treatment.

Complex therapy is prescribed in courses that are repeated every few months.

In conclusion of our conversation, it should be noted that optic nerve atrophy cannot be cured by non-traditional means. You will only lose time. The pathological process will progress, increasingly reducing the chances of successful treatment and restoration of vision.

Therefore, if you have the symptoms described above, or other symptoms indicating the development of pathology, do not waste precious time and make an appointment with an experienced ophthalmologist. With timely treatment, the chances of restoring vision are significantly increased. Be healthy!

19-12-2012, 14:49

Description

is not an independent disease. This is a consequence of a variety of pathological processes affecting different parts of the visual pathway. It is characterized by decreased visual function and blanching of the optic disc.

Etiology

Development of optic nerve atrophy cause various pathological processes in the optic nerve and retina(inflammation, dystrophy, edema, circulatory disorders, the action of toxins, compression and damage to the optic nerve), diseases of the central nervous system, general diseases of the body, hereditary causes.

lead to optic nerve atrophy common diseases. This happens with poisoning with ethyl and methyl alcohols, tobacco, quinine, chlorophos, sulfonamides, lead, carbon disulfide and other substances, with botulism. Vascular diseases can cause acute or chronic circulatory disorders in the vessels of the optic nerve with the development of ischemic foci and softening foci in it (colliquation necrosis). Essential and symptomatic hypertension, atherosclerosis, diabetes mellitus, internal profuse bleeding, anemia, diseases of the cardiovascular system, starvation, beriberi can lead to atrophy of the optic nerve.

In the etiology of optic nerve atrophy are important and diseases of the eyeball. These are lesions of the retina of vascular origin (with hypertensive angiosclerosis, atherosclerosis, involutional changes), retinal vessels (inflammatory and allergic vasculitis, obstruction of the central artery and central vein of the retina), degenerative diseases of the retina (including retinitis pigmentosa), complications of uveitis (papillitis, chorioretinitis), retinal detachment, primary and secondary glaucoma (inflammatory and post-inflammatory, flicogenic, vascular, dystrophic, traumatic, postoperative, neoplastic). Prolonged hypotension of the eyeball after surgery, inflammatory degenerative diseases of the ciliary body, penetrating wounds of the eyeball with the formation of a fistula lead to edema of the optic nerve head (stagnant nipple), after which atrophy of the optic nerve head develops.

In addition to Leber's hereditary atrophy and hereditary infantile optic atrophy, hereditary causes play a role in the occurrence of atrophy in drusen of the optic nerve head. Diseases and deformities of the bones of the skull (tower-shaped skull, Crouzon's disease) also lead to atrophy of the optic nerves.

It should be noted that in practice the etiology of optic nerve atrophy is not always easy to establish. According to E. Zh. Tron, in 20.4% of patients with atrophy of the optic nerves, its etiology was not established.

Pathogenesis

The nerve fibers of the peripheral neuron of the visual pathway can be exposed to various influences. This inflammation, non-inflammatory edema, dystrophy, circulatory disorders, the action of toxins, damage, compression (tumor, adhesions, hematomas, cysts, sclerotic vessels, aneurysms), which leads to the destruction of nerve fibers and their replacement with glial and connective tissue, obliteration of the capillaries that feed them .

In addition, with an increase in intraocular pressure, it develops collapse of the glial cribriform membrane of the optic disc, which leads to degeneration of nerve fibers in vulnerable areas of the disc, and then to disc atrophy with excavation resulting from direct compression of the disc and secondary microcirculation disorders.

Classification

On the ophthalmoscopic picture, they distinguish primary (simple) and secondary atrophy of the optic nerve. Primary atrophy occurs on a disc that has not been changed before. With simple atrophy, nerve fibers are promptly replaced by proliferating elements of glia and connective tissue that take their places. The borders of the disk remain distinct. Secondary atrophy of the optic disc occurs on the altered disc due to its edema (congestive nipple, anterior ischemic neuropathy) or inflammation. In place of the dead nerve fibers, as in primary atrophy, glia elements penetrate, but this occurs more rapidly and in large sizes, as a result of which rough scars are formed. The boundaries of the optic nerve head are not distinct, washed away, its diameter can be increased. The division of atrophy into primary and secondary is conditional. With secondary atrophy, the borders of the disk are only fuzzy at first, with time the edema disappears, and the borders of the disk become clear. Such atrophy is no different from simple. Sometimes glaucomatous (marginal, cavernous, cauldron-shaped) atrophy of the optic nerve head is isolated in a separate form. With it, there is practically no proliferation of glia and connective tissue, and as a result of direct mechanical action of increased intraocular pressure, the optic disc is squeezed (excavated) as a result of the collapse of its glial-lattice membrane.

Atrophy of the optic disc, depending on the degree of color loss detected during ophthalmoscopy, is divided into initial, partial, incomplete and complete. With initial atrophy, against the background of a pink disc color, a slight blanching appears, which later becomes more intense. With the defeat of not the entire diameter of the optic nerve, but only part of it, partial atrophy of the optic nerve head develops. So, with the defeat of the papillomacular bundle, blanching of the temporal half of the optic disc occurs. With further spread of the process, partial atrophy can spread to the entire nipple. With diffuse spread of the atrophic process, uniform blanching of the entire disc is noted. If at the same time visual functions are still preserved, then they speak of incomplete atrophy. With complete atrophy of the optic nerve, the blanching of the disc is total and the visual functions of the affected eye are completely lost (amaurosis). In the optic nerve, not only visual, but also reflex nerve fibers pass, therefore, with complete atrophy of the optic nerve, the direct pupillary reaction to light is lost on the side of the lesion, and the friendly reaction is lost on the other eye.

Topically allocate ascending and descending optic nerve atrophy. Retinal ascending atrophy (wax, valerian) occurs in inflammatory and degenerative processes in the retina due to the primary lesion of the visual ganglionic neurocytes of the ganglionic layer of the retina. The optic disc becomes grayish-yellow, the vessels of the disc narrow, their number decreases. Ascending atrophy does not develop when only the neuroepithelial layer of the retina (rods and cones) is affected. Descending optic nerve atrophy occurs when a peripheral neuron of the optic pathway is damaged and slowly descends to the optic nerve head. Having reached the optic nerve head, the atrophic process changes it according to the type of primary atrophy. Descending atrophy spreads more slowly than ascending. The closer the process is to the eyeball, the faster the atrophy of the optic disc appears in the fundus. Thus, damage to the optic nerve at the point of entry into it of the central retinal artery (10-12 mm behind the eyeball) causes atrophy of the optic nerve head in 7-10 days. Damage to the intraorbital segment of the optic nerve before the entry of the central retinal artery into it leads to the development of atrophy of the optic nerve head in 2-3 weeks. With retrobulbar neuritis, atrophy descends to the fundus of the eye within 1-2 months. With injuries of the chiasm, descending atrophy descends to the fundus 4-8 weeks after the injury, and with slow compression of the chiasm by pituitary tumors, atrophy of the optic disc develops only after 5-8 months. Thus, the rate of spread of descending atrophy is also related to the type and intensity of the pathological process that affects the peripheral neuron of the visual pathway. They matter and blood supply conditions: the atrophic process develops faster with a deterioration in the blood supply to the nerve fibers. Atrophy of the optic discs in case of damage to the optic tract occurs about a year after the onset of the disease (with injuries of the optic tract, somewhat faster).

Optic atrophy may be stationary and progressive, which is evaluated in the process of dynamic examination of the fundus and visual functions.

When one eye is affected, it is said unilateral, with damage to both eyes - o bilateral optic nerve atrophy. Atrophy of the optic nerves in intracranial processes is more often bilateral, but the degree of its severity is different. Occurs in intracranial processes and unilateral atrophy of the optic nerve, which is especially common when the pathological focus is localized in the anterior cranial fossa. Unilateral atrophy in intracranial processes may be the initial stage of bilateral. In violation of blood circulation in the vessels of the optic nerve, intoxication, the process is usually bilateral. Unilateral atrophy occurs with damage to the optic nerve, pathological processes in the orbit, or due to unilateral pathology of the eyeball.

Ophthalmoscopic picture

With optic nerve atrophy, there is always blanching of the optic disc A. Often, but not always, there is vasoconstriction of the optic disc.

With primary (simple) atrophy the borders of the disk are clear, its color is white or grayish-white, bluish or slightly greenish. In redless light, the contours of the disc remain clear or become sharper, while the contours of a normal disc are veiled. In red (purple) light, the atrophic disc becomes blue. The cribriform plate (lamina cribrosa), through which the optic nerve passes when it enters the eyeball, is very little translucent. The translucence of the cribriform plate is due to a decrease in the blood supply to the atrophied disc and less than with secondary atrophy, the growth of glial tissue. Disc blanching can vary in intensity and distribution. With initial atrophy, a slight but distinct blanching appears against the background of the pink color of the disc, then it becomes more intense with a simultaneous weakening of the pink tint, which then completely disappears. With advanced atrophy, the disc is white. At this stage of atrophy, vasoconstriction is almost always noted, and the arteries are narrowed more sharply than the veins. The number of vessels on the disk also decreases. Normally, about 10 small vessels pass through the edge of the disc. With atrophy, their number decreases to 7-6, and sometimes up to three (Kestenbaum's symptom). Sometimes with primary atrophy, a slight excavation of the optic nerve head is possible.

With secondary atrophy disk borders are indistinct, washed away. Its color is gray or dirty gray. The vascular funnel or physiological excavation is filled with connective or glial tissue, the cribriform plate of the sclera is not visible. These changes are usually more pronounced in atrophy after congestive nipple than in atrophy after optic neuritis or anterior ischemic neuropathy.

Retinal wax atrophy of the optic disc distinguished by its yellow wax color.

With glaucoma increased intraocular pressure causes the appearance of glaucomatous excavation of the optic disc. In this case, at first the vascular bundle of the disc is displaced to the nasal side, then excavation of the nipple gradually develops, which gradually increases. The color of the disc becomes whitish and pale. Cauldron-shaped excavation covers almost the entire disc up to its edges (cauldron-shaped, marginal excavation), which distinguishes it from physiological excavation, which has the shape of a funnel that does not reach the edges of the disc and does not displace the vascular bundle to the nasal side. Vessels at the edge of the disk are bent over the edge of the recess. In advanced stages of glaucoma, the excavation captures the entire disc, which becomes completely white, and the vessels on it are severely constricted.

Cavernous atrophy occurs when the vessels of the optic nerve are damaged. The atrophic optic disc begins to bulge under the influence of normal intraocular pressure with the appearance of excavation, while excavation of a normal disc requires increased intraocular pressure. Excavation of the disc in cavernous atrophy is facilitated by the fact that the growth of glia is small, and therefore no additional resistance is created to prevent excavation.

visual functions

Visual acuity of patients with optic nerve atrophy depends on the location and intensity of the atrophic process. If the papillomacular bundle is affected, then visual acuity is significantly reduced. If the papillomacular bundle is affected slightly, and the peripheral fibers of the optic nerve suffer more, then visual acuity does not decrease much. If there is no damage to the papillomacular bundle, and only the peripheral fibers of the optic nerve are affected, then visual acuity does not change.

Visual field changes with atrophy of the optic nerve are important in topical diagnosis. They depend to a greater extent on the localization of the pathological process and to a lesser extent on its intensity. If the papillomacular bundle is affected, then a central scotoma occurs. If the peripheral fibers of the optic nerve are affected, then narrowing of the peripheral boundaries of the visual field develops (uniform along all meridians, uneven, sector-shaped). If atrophy of the optic nerve is associated with damage to the chiasm or the optic tract, then hemianopia (homonymous and heteronymous) occur. Hemianopia in one eye occurs when the intracranial part of the optic nerve is damaged.

Disorders of color vision more often occur and are clearly expressed with atrophy of the optic nerve head that occurs after neuritis, and rarely with atrophy after edema. First of all, the color perception for green and red suffers.

Often with atrophy of the optic nerves changes in the fundus correspond to changes in visual functions, but this is not always the case. So, with descending atrophy of the optic nerve, visual functions can be greatly changed, and the fundus of the eye remains normal for a long time until the atrophic process descends to the optic nerve head. Perhaps a pronounced blanching of the optic nerve head in combination with a slight change in visual functions. This can be with multiple sclerosis, when the death of myelin sheaths in the plaque area occurs while the axial cylinders of nerve fibers are preserved. Pronounced blanching of the disc with the preservation of visual functions may also be associated with the peculiarity of the blood supply in the region of the cribriform plate of the sclera. This area is supplied with blood from the posterior short ciliary arteries, the deterioration of blood flow through them causes intense blanching of the disc. The rest (orbital) part of the optic nerve is supplied with blood from the anterior and posterior arteries of the optic nerve, that is, from other vessels.

With blanching of the optic nerve head, combined with the normal state of visual functions, it is necessary to study the visual field using campimetry to detect small visual defects. In addition, you need to collect an anamnesis about the initial visual acuity, since sometimes visual acuity can be higher than one, and in these cases, its decrease to one may indicate the influence of an atrophic process.

With unilateral atrophy a thorough study of the functions of the second eye is necessary, since unilateral atrophy can only be the beginning of bilateral, which often happens with intracranial processes. Changes in the visual field of the other eye indicate a bilateral process and acquire important topical diagnostic value.

Diagnostics

In severe cases, diagnosis is not difficult. If the pallor of the optic disc is insignificant (especially temporal, since the temporal half of the disc is normally somewhat paler than the nasal one), then a long-term study of visual functions in dynamics helps to establish the diagnosis. At the same time, it is necessary pay special attention to the study of the field of view for white and colored objects. Facilitate diagnosis Electrophysiological, X-ray and fluorescent angiographic studies. Characteristic changes in the visual field and an increase in the threshold of electrical sensitivity (up to 400 μA at a norm of 40 μA) indicate atrophy of the optic nerve. The presence of marginal excavation of the optic disc and an increase in intraocular pressure indicate glaucomatous atrophy.

Sometimes it is difficult only by the presence of atrophy of the disc in the fundus to establish the type of lesion of the optic nerve or the nature of the underlying disease. Washing out of the borders of the disc during atrophy indicates that it was the result of edema or inflammation of the disc. It is necessary to study the anamnesis in more detail: the presence of symptoms of intracranial hypertension indicates the post-congestive nature of the atrophy. The presence of simple atrophy with clear boundaries does not exclude its inflammatory origin. So, descending atrophy on the basis of retrobulbar neuritis and inflammatory processes of the brain and its membranes causes disc changes in the fundus of the eye according to the type of simple atrophy. The nature of atrophy(simple or secondary) is of great importance in diagnosis, since certain diseases lead to certain, “favorite” types of damage to the optic nerves. For example, compression of the optic nerve or chiasm by a tumor leads to the development of simple atrophy of the optic nerves, tumors of the ventricles of the brain - to the development of congestive nipples and then to secondary atrophy. However, the diagnosis is complicated by the fact that some diseases, such as meningitis, arachnoiditis, neurosyphilis, can be accompanied by both simple and secondary atrophy of the optic discs. In this case, concomitant eye symptoms matter: changes in the vessels of the retina, the retina itself, the choroid, as well as a combination of atrophy of the optic nerves with a disorder of pupillary reactions.

When assessing the degree of color loss and blanching of the optic disc it is necessary to take into account the general background of the fundus. Against the parquet background of the fundus in brunettes, even a normal or slightly atrophied disc appears paler and whiter. Against a light background of the fundus, the atrophic nipple may not look so pale and white. In severe anemia, the optic discs are completely white, but more often a faint pink tint is retained. In hypermetropes, the optic discs in the normal state are more hyperemic, and with a high degree of hypermetropia, there may be a picture of false neuritis (severe hyperemia of the nipples). In myopia, the optic discs are paler than in emmetropes. The temporal half of the optic disc is normally slightly paler than the nasal one.

Optic nerve atrophy in some diseases

brain tumors . Secondary atrophy of the optic nerve in brain tumors is a consequence of congestive nipples. More often it happens with tumors of the cerebellopontine angle, hemispheres and ventricles of the brain. With subtentorial tumors, secondary atrophy is less common than with supratentorial ones. The incidence of secondary atrophy is affected not only by the location, but also by the nature of the tumor. It is more common in benign tumors. Especially rarely, it develops with metastases of malignant tumors in the brain, since death occurs earlier than congestive nipples turn into secondary atrophy.

Primary (simple) atrophy of the optic nerve occurs when compression of a peripheral neuron of the optic pathway. Most often, the chiasm is affected, less often the intracranial part of the optic nerve, and even more rarely the optic tract. Simple atrophy of the optic nerve is characteristic of supratentorial brain tumors, especially often it is caused by tumors of the chiasmal-sellar region. Rarely, primary atrophy of the optic nerves occurs with subtentorial tumors as a symptom at a distance: compression of the peripheral neuron of the optic pathway is carried out through an expanded ventricular system or by dislocation of the brain. Primary optic nerve atrophy rarely occurs with tumors of the ventricles of the cerebral hemispheres, cerebellum and cerebellopontine angle, and secondary atrophy in tumors of this localization is common. Rarely, simple atrophy of the optic nerves develops in malignant tumors and often in benign ones. Primary atrophy of the optic nerves is usually caused by benign tumors of the sella turcica (pituitary adenomas, craniopharyngiomas) and meningiomas of the lesser wing of the sphenoid bone and olfactory fossa. Optic nerve atrophy develops in Foster Kennedy syndrome: simple atrophy in one eye and congestive nipple with a possible transition to secondary atrophy in the other eye.

brain abscesses . Congestive discs often develop, but they rarely progress to secondary optic nerve atrophy, since the increase in intracranial pressure is not so long-lasting, since intracranial hypertension either decreases after surgery, or patients do not live to see congestive nipples turn into secondary atrophy. Rarely, Foster Kennedy syndrome occurs.

Optochiasmatic arachnoiditis . More often, primary atrophy of the optic discs occurs in the form of blanching of the entire nipple or its temporal half (partial atrophy). In isolated cases, blanching of the upper or lower half of the disc is possible.

Secondary atrophy of the optic discs in optochiasmal arachnoiditis can be postneuritic (transition of inflammation from the meninges to the optic nerve) or postcongestive (occurs after congestive nipples).

Arachnoiditis of the posterior cranial fossa . Often lead to the development of pronounced congestive nipples, which then turn into secondary atrophy of the optic discs.

Aneurysms of the vessels of the base of the brain . Anterior circle of Willis aneurysms often press on the intracranial optic nerve and chiasm, resulting in simple optic atrophy. Simple atrophy due to compression of the optic nerve is unilateral, always located on the side of the aneurysm. With pressure on the chiasm, bilateral simple atrophy occurs, which may first occur in one eye and then appear in the other. Unilateral simple atrophy of the optic nerve most often occurs with aneurysms of the internal carotid artery, less often with aneurysms of the anterior cerebral artery. Aneurysms of the vessels of the base of the brain are most often manifested by unilateral paralysis and paresis of the nerves of the oculomotor apparatus.

Thrombosis of the internal carotid artery . The presence of an alternating optic-pyramidal syndrome is characteristic: blindness of the eye with simple atrophy of the optic disc on the side of thrombosis, combined with hemiplegia on the other side.

Tabes dorsalis and progressive paralysis . In tabes and progressive paralysis, atrophy of the optic nerves is usually bilateral and has the character of simple atrophy. Atrophy of the optic nerves in tabes is more common than in progressive paralysis. The atrophic process begins with peripheral fibers and then slowly goes deep into the optic nerve, so there is a gradual decrease in visual functions. Visual acuity gradually decreases with varying degrees of severity in both eyes up to bilateral blindness. Fields of vision gradually narrow, especially on colors, in the absence of cattle. Atrophy of the optic nerve with tabes usually develops in the early period of the disease, when other neurological symptoms (ataxia, paralysis) are not expressed or absent. Tabes is characterized by a combination of simple optic nerve atrophy with Argil Robertson's symptom. Reflex immobility of the pupils in tabes is often combined with miosis, anisocoria, and pupillary deformity. Argil Robertson's symptom also occurs with syphilis of the brain, but much less frequently. Secondary atrophy of the optic discs (postcongestive and postneuritic) speaks against tabes and often occurs with cerebral syphilis.

Atherosclerosis . Atrophy of the optic nerve in atherosclerosis occurs as a result of direct compression of the optic nerve by a sclerotic carotid artery or as a result of damage to the vessels supplying the optic nerve. Primary atrophy of the optic nerve develops more often, secondary atrophy is much less common (after disc edema due to anterior ischemic neuropathy). Often there are sclerotic changes in the vessels of the retina, but these changes are also characteristic of syphilis, hypertension and kidney disease.

Hypertonic disease . Optic nerve atrophy may be due to neuroretinopathy. This is secondary disc atrophy with accompanying symptoms characteristic of hypertensive angioretinopathy.

With hypertension, optic nerve atrophy may occur as an independent process, not associated with changes in the retina and retinal vessels. In this case, atrophy develops due to damage to the peripheral neuron of the visual pathway (nerve, chiasm, tract) and is in the nature of primary atrophy.

Profuse bleeding . After profuse bleeding (gastrointestinal, uterine) after a more or less long time, from several hours to 3-10 days, anterior ischemic neuropathy may develop, after which secondary atrophy of the optic discs develops. The lesion is usually bilateral.

Leber's optic nerve atrophy . Family hereditary atrophy of the optic nerves (Leber's disease) is observed in men aged 16-22 years in several generations and is transmitted through the female line. The disease proceeds as a bilateral retrobulbar neuritis, starting with a sharp drop in vision. A few months later, simple atrophy of the optic discs develops. Sometimes the entire nipple turns pale, sometimes only the temporal halves. Complete blindness usually does not occur. Some authors believe that Leber's atrophy is a consequence of optochiasmal arachnoiditis. The type of inheritance is recessive, linked to the X chromosome.

Hereditary infantile optic nerve atrophy . Children 2-14 years old are ill. Gradually, simple atrophy of the optic nerves develops with temporal blanching of the disc, less often the nipple. Often, high visual acuity is preserved, there is never blindness in both eyes. Often there are central scotomas in the field of view of both eyes. Color perception is usually impaired, and more blue than red and green. The type of inheritance is dominant, that is, the disease is transmitted from sick fathers and sick mothers to both sons and daughters.

Diseases and deformities of the bones of the skull . In early childhood, with a tower-shaped skull and Crouzon's disease (craniofacial dysostosis), congestive nipples may develop, after which secondary atrophy of the optic discs of both eyes develops.

Principles of treatment

Treatment of patients with atrophy of the optic nerves is carried out taking into account its etiology. Patients with optic nerve atrophy, which has developed due to compression of the peripheral neuron of the optic pathway by the intracranial process, require neurosurgical treatment.

To improve the blood supply to the optic nerve use vasodilators, vitamin preparations, biogenic stimulants, neuroprotectors, infusion of hypertonic solutions. Perhaps the use of oxygen therapy, blood transfusions, the use of heparin. In the absence of contraindications, physiotherapy is used: ultrasound on the open eye and endonasal drug electrophoresis of vasodilators, vitamin preparations, lecozyme (papain), lidase; apply electrical and magnetic stimulation of the optic nerves.

Forecast

Prognosis of optic nerve atrophy always serious. In some cases, you can count on the preservation of vision. With developed atrophy, the prognosis is unfavorable. Treatment of patients with atrophy of the optic nerves, whose visual acuity was less than 0.01 for several years, is ineffective.

Article from the book: .

Optic nerve atrophy is characterized by the development of the process of complete or partial death of nerve fibers, accompanied by the replacement of healthy connective tissues.

Types of disease

Atrophy of the optic disc, depending on its etiology, is divided into several types. These include:

1. Primary form (ascending and descending atrophy of the optic nerve). This pathological process develops as an independent disease. The descending type is diagnosed much more often than the ascending one. Such a disease is usually observed in males, since it is linked only to the X chromosome. The first manifestations of the disease occur at about 15-25 years of age. In this case, damage directly to the nerve fibers occurs.
2. Secondary atrophy of the optic nerve. In this case, the pathological process develops against the background of other diseases. In addition, the violation may be due to a failure in the flow of blood to the nerve. A disease of this nature can appear in any person, regardless of his age and gender.

According to the nature of the course, the following types of this disease are distinguished:

1. Partial atrophy of the optic nerve (initial). The main difference of this type is the partial preservation of visual ability, which is most important in case of impaired vision (which is why wearing glasses or contact lenses is not able to improve the quality of vision). Although residual visual ability is usually salvageable, failures in color vision often occur. Those portions of the fields of view that have been saved will still be available.
2. Complete atrophy of the optic nerve. In this case, the symptoms of the disease have some similarities with such eye pathologies as cataracts and amblyopia. In addition, this type of disease can manifest itself in a non-progressive form that does not have specific symptoms. This fact indicates that the state of the necessary visual functions remains stable. However, most often there is a progressive form of pathology, during which there is a rapid loss of vision, which, as a rule, cannot be restored. This greatly complicates the diagnostic process.

Symptoms

If atrophy of the optic nerve develops, the symptoms manifest themselves mainly in the form of a deterioration in the quality of vision at the same time in both eyes or only one. Restoration of visual ability in this case is impossible. Depending on the type of pathology, this symptom may have a different manifestation.

As the disease progresses, vision gradually deteriorates. In the most severe cases, complete atrophy of the optic nerve occurs, which provokes a complete loss of the ability to see. This process can last for many weeks, or it can develop in a couple of days.

If partial atrophy of the optic nerve is observed, there is a gradual slowdown in progression, after which it completely stops at a certain stage. At the same time, visual activity ceases to decrease.

Signs of optic nerve atrophy often appear in the form. Usually there is their narrowing, which is characterized by loss of lateral vision. This symptom can be almost imperceptible, but sometimes tunnel vision occurs, that is, when the patient is able to see only those objects that are localized directly in the direction of his gaze, as if through a thin tube. Very often, with atrophy, dark, light or colored spots appear before the eyes, and it becomes difficult for a person to distinguish colors.

The appearance of dark or white spots before the eyes (both closed and open) indicates that the destruction process affects the nerve fibers that are located in the central part of the retina or very close to it. The narrowing of the visual fields begins if the peripheral nerve tissues have been affected.

With a more extensive distribution of the pathological process, most of the visual field may disappear. This type of disease can spread to only one eye or affect both at once.

Causes

The causes of optic nerve atrophy can be different. Both acquired diseases and congenital ones, which are directly related to the visual organs, act as a provoking factor.

The appearance of atrophy can be triggered by the development of diseases that directly affect the nerve fibers or the retina of the eye. The following pathological processes can be cited as examples:

• mechanical damage (burn or injury) of the retina;
• inflammatory processes;
• optic nerve dystrophy (ODN) of a congenital nature;
• fluid retention and swelling;
• toxic effects of certain chemicals;
• impaired access of blood to nerve tissues;
• compression of certain parts of the nerve.

In addition, diseases of the nervous and other body systems play an important role in the development of this pathological process.

Quite often, the onset of this pathological condition is due to the development of diseases that directly affect the human central nervous system. It can be;

• syphilitic brain damage;
• development of abscesses;
• neoplasms of a different nature in the brain;
• meningitis;
• encephalitis;
• mechanical damage to the skull;
• development of multiple sclerosis.

More rare causes are alcohol poisoning of the body and intoxication with other chemicals.

Sometimes such a pathology develops against the background of hypertension or atherosclerosis, as well as other cardiovascular diseases. In rare cases, the cause may be a lack of vitamins and macronutrients in the human body.

In addition to these reasons, the development of an atrophic disorder can be affected by obstruction of the central or peripheral retinal arteries. This is because these arteries provide nutrients to the organ. As a result of their blockage, metabolism is disturbed, which provokes a deterioration in the general condition. Quite often, obstruction is a consequence of the development of glaucoma.

Diagnostics

During the examination of the patient, the doctor must necessarily identify the presence of concomitant diseases, the fact of the use of certain drugs and contact with caustic substances, the presence of bad habits and symptoms indicating the development of intracranial disorders.

In most cases, the diagnosis of diseases of this nature does not cause great difficulties. In order to determine an accurate diagnosis, it is necessary first of all to check the quality of visual function, namely, to determine the visual acuity and visual fields and to conduct tests for color perception. This is followed by ophthalmoscopy. This procedure allows you to identify the pallor of the optic disc and the decrease in the lumen of the fundus vessels, which are characteristic of such a disease. Another mandatory procedure is.

Very often, diagnostics involves the use of the following instrumental methods:

• x-ray examination;
• magnetic resonance imaging (MRI);
• computed tomography of the brain;
• electrophysiological diagnostics;
• contrast methods (used to determine the patency of retinal vessels).

Mandatory laboratory diagnostic methods are carried out, in particular, general and biochemical blood tests.

Methods of treatment

Treatment for atrophy of the optic nerve should be carried out immediately after diagnosis. It should be remembered that it is impossible to completely get rid of the disease, but it is quite possible to slow down its progression and even stop it.

During therapy, it is necessary to take into account the fact that this pathological process is not an independent disease, but the result of diseases that affect one or another part of the visual organ. Therefore, in order to cure optic nerve atrophy, it is necessary first of all to eliminate the provoking factor.

In most cases, complex therapy is used, involving the use of drugs and optical surgery. Treatment can be carried out with the following medications:

• vasodilators (Papaverine, Dibazol, Sermion);
• anticoagulants (Heparin);
• drugs that improve metabolism (aloe extract);
• vitamin complexes;
• enzyme preparations (Lidase, Fibrinolysin);
• means that increase immunity (eleutherococcus extract);
• hormonal anti-inflammatory drugs (Dexamethasone);
• drugs that improve the functioning of the central nervous system (Nootropil, Emoksipin).

The listed medicines can be used in the form of tablets, solutions, eye drops and injections. In the most severe cases, surgery is needed. Many are interested in whether such a disease can be cured only by conservative methods. Sometimes this is possible, but only a specialist can answer the question of how to treat atrophy in a particular case.

Any drug should be taken only after the appointment of the attending physician, observing the prescribed dosage. It is strictly forbidden to choose drugs on your own.

Quite often, physiotherapy procedures are performed during the treatment of optic nerve atrophy. Especially effective are acupuncture or laser and magnetic stimulation of the optic nerve.

In some cases, treatment with folk remedies can be used. To restore the optic nerve, various infusions and decoctions of medicinal plants are used. However, this method can only be used as an additional therapy in combination with traditional medicine and only after consultation with your doctor.

Surgical intervention is usually prescribed in the presence of neoplasms of a different nature and hereditary atrophy of the optic nerve. Surgery is required if there are congenital anomalies in the development of the visual organ, such as Leber's optic nerve atrophy.

Currently, the following methods of surgical intervention are used for Leber's optic nerve atrophy and other congenital disorders:

• extrascleral methods (the most common type of surgical intervention for ocular pathologies);
• vasoconstructive therapy;
• decompression methods (used very rarely).

With this pathology, the symptoms and treatment are interrelated, since the doctor prescribes therapy depending on the symptoms and the type of disease.

In order not to risk your vision, self-medication is strictly prohibited. At the first symptoms of a violation, it is recommended to seek help from a doctor. In this case, you should find a suitable clinic where you can cure the disease most effectively.

Forecast and prevention

Timely detection of complete or partial atrophy of the optic nerve and its treatment can prevent the development of destructive disorders in the tissues. Properly prescribed therapy will help maintain the quality of visual function, and sometimes even improve it. However, it is impossible to achieve a complete restoration of vision due to severe damage and death of nerve fibers.

The lack of timely treatment can provoke very serious complications that lead not only to a decrease in vision, but also to its complete loss. In this case, the prognosis is disappointing, since it will no longer be possible to restore visual ability.

In order to prevent the development of this pathological process, the following rules must be observed:

• engage in the prevention and timely treatment of any infectious and inflammatory diseases of the body;
• prevent mechanical damage to the eye tissue and brain injury;
• periodically undergo an examination by a doctor and carry out all the necessary diagnostic measures for the early detection of diseases;
• stop smoking;
• remove alcoholic beverages from life;
• regularly measure blood pressure;
• adhere to proper nutrition;
• to live an active lifestyle;
• take regular walks in the fresh air.

A disease of this nature is very serious, therefore, at the first symptoms, it is imperative to consult a specialist and in no case self-medicate.

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