Home Hygiene Optic disc atrophy. Treatment of optic atrophy

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Optic disc atrophy. Treatment of optic atrophy

Optic nerve atrophy is the complete or partial destruction of its fibers with their replacement by connective tissue.

Causes of optic nerve atrophy

The causes of visual atrophy include heredity and congenital pathology; it can be a consequence of various eye diseases, pathological processes in the retina and optic nerve (inflammation, dystrophy, trauma, toxic damage, swelling, congestion, various circulatory disorders, compression of the optic nerve, etc.), pathology of the nervous system or general diseases.

More often, optic nerve atrophy develops as a result of pathology of the central nervous system (tumors, syphilitic lesions, brain abscesses, encephalitis, meningitis, multiple sclerosis, skull injuries), intoxication, alcohol poisoning with methyl alcohol, etc.

Also, the causes of the development of optic nerve atrophy can be hypertension, atherosclerosis, quinine poisoning, vitamin deficiency, fasting, and profuse bleeding.

Optic nerve atrophy occurs as a result of obstruction of the central and peripheral retinal arteries supplying the optic nerve, and it is also the main symptom of glaucoma.

Symptoms of optic atrophy

There are primary and secondary atrophy of the optic nerves, partial and complete, complete and progressive, unilateral and bilateral.

The main symptom of optic nerve atrophy is a decrease in visual acuity that cannot be corrected. Depending on the type of atrophy, this symptom manifests itself differently. Thus, as atrophy progresses, vision gradually decreases, which can lead to complete atrophy optic nerve and, accordingly, to complete loss of vision. This process can take place from several days to several months.

With partial atrophy, the process stops at some stage and vision stops deteriorating. Thus, progressive atrophy of the optic nerves is distinguished and complete.

Visual impairment due to atrophy can be very diverse. This can be a change in visual fields (usually narrowing, when “lateral vision” disappears), up to the development of “tunnel vision”, when a person looks as if through a tube, i.e. sees objects that are only directly in front of him, and scotomas often appear, i.e. dark spots in any part of the visual field; It could also be a color vision disorder.

Changes in visual fields can be not only “tunnel”, it depends on the localization of the pathological process. Thus, the appearance of scotomas (dark spots) right before the eyes indicates damage to nerve fibers closer to the central or directly in the central part of the retina; narrowing of the visual fields occurs due to damage to peripheral nerve fibers; with deeper lesions of the optic nerve, half of the visual field (or temporal , or nasal). These changes can occur in one or both eyes.

Examination for suspected optic nerve atrophy

It is unacceptable to engage in self-diagnosis and self-medication for this pathology, because something similar happens with peripheral cataracts, when lateral vision is first impaired, and then the central parts are involved. Also, optic atrophy can be confused with amblyopia, in which vision can also be significantly reduced and cannot be corrected. It is worth noting that the above pathology is not as dangerous as optic nerve atrophy. Aatrophy can be not only an independent disease or a consequence of some local pathology in the eye, but also a symptom of serious, and sometimes fatal disease nervous system, so it is very important to establish the cause of optic nerve atrophy as early as possible.

If similar symptoms occur, you should immediately contact an ophthalmologist and neurologist. These two specialists are primarily involved in the treatment of this disease. There is also a separate branch of medicine - neuro-ophthalmology, doctors - neuro-ophthalmologists, who are engaged in the diagnosis and treatment of such pathologies. If necessary, neurosurgeons, therapists, otorhinolaryngologists, infectious disease specialists, oncologists, toxicologists, etc. can also take part in diagnosis and treatment.

Diagnosis of optic atrophy is usually not difficult. It is based on the determination of visual acuity and fields (perimetry), on the study of color perception. An ophthalmologist must perform an ophthalmoscopy, during which he detects blanching of the optic nerve head, narrowing of the vessels of the fundus and measures intraocular pressure. A change in the contours of the optic nerve head indicates the primary or secondary nature of the disease, i.e. if its contours are clear, then most likely the disease has developed for no apparent reason, but if the contours are blurred, then perhaps it is post-inflammatory or post-stagnant atrophy.

If necessary, an X-ray examination is carried out (craniography with a mandatory image of the sella region), computed tomography or magnetic resonance imaging of the brain, electrophysiological research methods and fluorescein angiographic methods, in which the patency of the retinal vessels is checked using a special substance administered intravenously.

Laboratory research methods can also be informative: a general blood test, a biochemical blood test, a test for syphilis or borelliosis.

Treatment of optic atrophy

Treatment of optic atrophy is a very difficult task for doctors. You need to know that destroyed nerve fibers cannot be restored. One can hope for some effect from treatment only by restoring the functioning of nerve fibers that are in the process of destruction, which still retain their vital activity. If this moment is missed, then vision in the affected eye can be lost forever.

When treating atrophy, it is necessary to keep in mind that this is often not an independent disease, but a consequence of other pathological processes affecting various departments visual path. Therefore, treatment of optic nerve atrophy must be combined with elimination of the cause that caused it. If the cause is eliminated in a timely manner and if atrophy has not yet developed, normalization of the fundus picture and recovery occurs within 2-3 weeks to 1-2 months. visual functions.

Treatment is aimed at eliminating edema and inflammation in the optic nerve, improving its blood circulation and trophism (nutrition), restoring the conductivity of not completely destroyed nerve fibers.

But it should be noted that the treatment of optic nerve atrophy is long-term, its effect is weak, and sometimes completely absent, especially in advanced cases. Therefore it should be started as early as possible.

As mentioned above, the main thing is the treatment of the underlying disease, against the background of which complex treatment of optic nerve atrophy is carried out. For this, various forms of drugs are prescribed: eye drops, injections, both general and local; tablets, electrophoresis. Treatment is aimed at

improvement of blood circulation in the vessels supplying the nerve - vasodilators (complamin, nicotinic acid, no-spa, papaverine, dibazol, aminophylline, trental, halidor, sermion), anticoagulants (heparin, ticlid);
to improve metabolic processes in nerve tissue and stimulate the restoration of altered tissue - biogenic stimulants (aloe extract, peat, vitreous, etc.), vitamins (ascorutin, B1, B2, B6), enzymes (fibrinolysin, lidase), amino acids (glutamic acid ), immunostimulants (ginseng, eleuthorococcus);
to resolve pathological processes and stimulate metabolism (phosphaden, preductal, pyrogenal); to relieve the inflammatory process - hormonal drugs(prednisolone, dexamethasone); to improve the functioning of the central nervous system (emoxipin, Cerebrolysin, Fezam, nootropil, Cavinton).

Medicines must be taken as prescribed by a doctor after diagnosis. The doctor will select the optimal treatment, taking into account concomitant diseases. In the absence of concomitant somatic pathology, you can independently take no-shpa, papaverine, vitamin preparations, amino acids, emoxypine, nootropil, fesam.

But self-medication with this serious pathology should not be done. Physiotherapeutic treatment and acupuncture are also used; methods of magnetic, laser and electrical stimulation of the optic nerve have been developed.

The course of treatment is repeated after several months.

Nutrition for optic nerve atrophy should be complete, varied and rich in vitamins. You need to eat as much fresh vegetables and fruits as possible, meat, liver, dairy products, cereals, etc.

If vision is significantly reduced, the issue of assigning a disability group is decided.

The visually impaired and the blind are prescribed a course of rehabilitation aimed at eliminating or compensating for the limitations in life that have arisen as a result of vision loss.

Treatment folk remedies It is dangerous because precious time is lost when it is still possible to cure atrophy and restore vision. It should be noted that for this disease, folk remedies are ineffective.

Complications of optic atrophy

The diagnosis of optic atrophy is very serious. At the slightest decrease in vision, you should immediately consult a doctor so as not to miss your chance of recovery. Without treatment and as the disease progresses, vision may disappear completely, and it will be impossible to restore it. In addition, it is very important to identify the cause of optic nerve atrophy and eliminate it as early as possible, because this can not only lead to loss of vision, but can also be fatal.

Prevention of optic atrophy

In order to reduce the risk of optic nerve atrophy, it is necessary to promptly treat diseases leading to atrophy, prevent intoxication, conduct blood transfusions in case of profuse bleeding and, of course, promptly consult a doctor in case of the slightest sign visual impairment.

Ophthalmologist E.A. Odnoochko

Optic disc atrophy (another name is optic neuropathy) is a destructive pathology that affects the nerve fibers that transmit visual impulses to the human brain. During the course of the disease, nerve fibers are replaced by connective tissue, which is physiologically incapable of performing visual functions. The consequences of atrophy can be moderate or severe (complete blindness).

Atrophy of the nervous tissue of the eye can be expressed in two forms: acquired and hereditary (congenital). Congenital is formed in a child as a result of diseases of genetic etiology. A disease acquired during life (ascending or descending atrophy) can be triggered by glaucoma, inflammation, myopia, profuse bleeding, hypertension or the presence of a brain tumor.

The main symptoms of damage to the nerve of the eyeballs are reduced to decreased visual acuity, which cannot be corrected independently with the help of flexible lenses or glasses. If atrophy is progressive, then vision can decrease significantly in a period from several days to 2-3 months. Sometimes the disease ends in complete blindness. In case of development of incomplete (partial) atrophy optic nerve vision drops to a certain level, and the process stops.

Visual dysfunction can manifest itself in the form of a narrowing of the visual field, when the lateral visibility of objects is completely absent. Next, tunnel lateral vision develops. If treatment is not promptly applied, small dark spots (scotomas) will begin to appear in areas of the patient’s field of vision. The disease is also accompanied by color perception disorder.

All of the above signs will be identified at the next appointment. at the ophthalmologist.

Diagnostics

An analysis of the state of the visual apparatus should begin with a visit to an ophthalmologist (ophthalmologist). Ophthalmoscopy involves examination of the patient's blood vessels and fundus, and instrumental examination of the optic nerve disc. After these manipulations, the doctor will voice the need for an in-depth examination.

To accurately diagnose optic nerve dystrophy, the following studies are necessary:

Fluorescein angiography. Using this method, you can examine even the smallest vessels of the visual organs. The procedure for highly sensitive photography occurs after the introduction of a special coloring substance into them. Thus, areas with impaired blood supply are detected;
General and biochemical blood test. A patient's blood test is necessary to identify possible infections and inflammatory processes that affect the functioning of the eyes;
Magnetic resonance and CT scan. The study helps to obtain a detailed, three-dimensional picture of the condition of the optic nerve and orbit on the screen of the tomograph. The complete image is formed from many slices, which are layered on top of each other. The methods are highly informative, non-contact, and make it possible to study the fundus and fibers of the human optic nerve;
X-ray examination of the skull or craniography. A photograph of the patient’s skull is necessary to exclude or determine compression of the optic nerve by the bones of the skull;
For glaucoma and concomitant nerve atrophy, tonometry can provide important information - measuring intraocular pressure.

In some cases, the ophthalmologist refers the patient for consultation to other specialized specialists: a neurosurgeon, neurologist, rheumatologist and vascular surgeon. Later, all data will be compared to make a final diagnosis.

Treatment

As medical practice shows, to implement full recovery It is not possible to repair the optic nerve with glaucoma, since the destroyed nerve fibers will never return to their previous state.

In order to at least partially cure optic nerve atrophy, therapeutic measures should be started as early as possible. You need to know that this dystrophy can be an independent disease, or it can only be a consequence of other certain processes of a pathological nature. In the case of the latter option, treatment will be aimed at identifying and stopping these pathologies. Complex therapy includes a whole course of using drugs in the form of tablets, injections, eye drops.

Therapeutic restoration of the optic nerve consists of the following stages:

Taking medications to improve the flow and circulation of blood entering the vessels. The so-called vasodilator medications include No-shpu, Eufillin, Papaverine, Sermion, tablets based on nicotinic acid. Anticoagulants (Heparin, Tiklid) showed excellent results.
The use of agents that stimulate the regeneration of atrophied tissues and metabolic processes in them. This type of preparation includes biostimulants (aloe extract, peat, vitreous), vitamin complexes(Ascorutin, group B1, B2, B6), specific enzymes (Lidase), immunostimulating agents (ginseng, tincture of Eleutherococcus), amino acids in the form of glutamic acid.
Atrophy of the optic nerve may be preceded by some kind of inflammatory process. It can be stopped with the help of hormonal drugs (Dexamethasone, Prednisolone).
An obligatory stage of treatment is to improve the functioning of the patient’s central nervous system. This can be achieved with the help of the following drugs: Cerebrolysin, Phezam, Nootropil. These medications should never be prescribed independently. Get recommendations from a specialist.
Physiotherapeutic procedures. Patients with partial or complete atrophy are advised to stimulate the optic nerve using magnetic or laser device. Electrophoresis and ultrasound will help in treatment.

Statistics show that treatment with folk remedies is ineffective and can cause irreparable harm, as a person wastes time and the disease gradually progresses.

In particularly severe and advanced cases, the patient will be prescribed surgical treatment. It involves eliminating tumors that compress areas of the optic nerve. It is possible to introduce biomaterials that will stimulate blood flow to the atrophied nerve.

The above treatment in combination gives positive result, but it must be repeated after a certain period of time.

If, even after therapy, vision continues to decline, then the person is assigned a disability of the corresponding group.

Prognosis for partial optic nerve atrophy

Partial atrophy, or the diagnosis of PAZN, is a condition in which a certain percentage of residual vision is preserved, but color perception is impaired and the visual fields are narrowed. This phenomenon cannot be corrected, but also does not progress.

They can provoke a destructive process, as with complete dystrophy. various diseases infectious nature, severe intoxication, hereditary factors, trauma, eye diseases such as glaucoma, inflammation, damage to retinal tissue. If a person has lost peripheral vision in one eye, they should immediately contact their local ophthalmologist.

CHAZN of both eyes is a disease whose symptoms are severe or moderate in severity. Characterized by a gradual deterioration of vision and its acuity, painful sensations during the movement of the eyeballs. Some patients develop tunnel vision, in which all visual vision is limited to objects that are just in front of the eyes. The final symptom is the appearance of scotomas or blind spots.

Peculiarity partial atrophy optic nerve is that correct and timely treatment gives a favorable prognosis. Of course, doctors will not be able to restore initial visual acuity. The main goal of therapy is to maintain vision at a constant level. Specialists prescribe vasodilators, drugs that improve metabolism and blood flow in the body.

All patients should additionally take multivitamins and immunostimulants.

Prevention

Measures to prevent partial loss of vision or complete blindness include timely contact with an ophthalmologist and proper treatment of diseases that cause atrophy processes. It is extremely important to try to avoid all kinds of injuries and damage associated with visual organs or cranial bone.

Optic nerve atrophy is clinically a set of symptoms: visual impairment (decreased visual acuity and development of visual field defects) and blanching of the optic nerve head. Optic nerve atrophy is characterized by a decrease in the diameter of the optic nerve due to a decrease in the number of axons.

Optic nerve atrophy occupies one of the leading places in the nosological structure, second only to glaucoma and degenerative myopia. Optic nerve atrophy is considered to be the complete or partial destruction of its fibers with their replacement by connective tissue.

According to the degree of decrease in visual functions, atrophy can be partial or complete. According to research data, it is clear that partial atrophy of the optic nerve affects men in 57.5%, and women in 42.5%. Most often, bilateral damage is observed (in 65% of cases).

The prognosis for optic atrophy is always serious, but not hopeless. Due to the fact that pathological changes are reversible, treatment of partial optic nerve atrophy is one of the important areas in ophthalmology. With adequate and timely treatment this fact makes it possible to achieve an increase in visual functions even with a long-term existence of the disease. Also in recent years, the number of this pathology of vascular origin has increased, which is associated with the growth of general vascular pathology - atherosclerosis, coronary heart disease.

Etiology and classification

By etiology
- hereditary: autosomal dominant, autosomal recessive, mitochondrial;
- non-hereditary.
According to the ophthalmoscopic picture - primary (simple); secondary; glaucomatous.
According to the degree of damage (preservation of functions): initial; partial; incomplete; complete.
According to the topical level of the lesion: descending; ascending.
By degree of progression: stationary; progressive.
According to the localization of the process: one-sided; bilateral.

There are congenital and acquired optic atrophy. Acquired optic atrophy develops as a result of damage to the optic nerve fibers (descending atrophy) or retinal cells (ascending atrophy).

Congenital, genetically determined optic nerve atrophy is divided into autosomal dominant, accompanied by an asymmetric decrease in visual acuity from 0.8 to 0.1, and autosomal recessive, characterized by a decrease in visual acuity, often to the point of practical blindness already in early childhood.

Descending acquired atrophy is caused by processes that damage the fibers of the optic nerve at various levels (orbit, optic canal, cranial cavity). The nature of the damage is different: inflammation, trauma, glaucoma, toxic damage, circulatory disorders in the vessels supplying the optic nerve, metabolic disorders, compression of the optic fibers by a space-occupying formation in the orbital cavity or in the cranial cavity, degenerative process, myopia, etc.).

Each etiological factor causes optic nerve atrophy with certain ophthalmoscopic features typical for it. However, there are characteristics common to optic atrophy of any nature: blanching of the optic disc and impaired visual function.

The etiological factors of optic nerve atrophy of vascular origin are diverse: these are vascular pathology, acute vascular neuropathies (anterior ischemic neuropathy, occlusion of the central artery and vein of the retina and their branches), and a consequence of chronic vascular neuropathies (with general somatic pathology). Optic nerve atrophy occurs as a result of obstruction of the central and peripheral retinal arteries that supply the optic nerve.

Ophthalmoscopically, narrowing of the retinal vessels and blanching of part or all of the optic nerve head are detected. Persistent blanching of only the temporal half occurs with damage to the papillomacular bundle. When atrophy is a consequence of disease of the chiasm or optic tracts, then there are hemianopic types of visual field defects.

Depending on the degree of damage to the optic fibers, and, consequently, on the degree of decrease in visual functions and blanching of the optic nerve head, initial, or partial, and complete atrophy of the optic nerve is distinguished.

Diagnostics

Complaints: gradual decrease in visual acuity ( varying degrees severity), changes in the visual field (scotomas, concentric narrowing, loss of visual fields), impaired color vision.

Anamnesis: the presence of space-occupying lesions of the brain, intracranial hypertension, demyelinating lesions of the central nervous system, lesions of the carotid arteries, systemic diseases (including vasculitis), intoxication (including alcohol), history of optic neuritis or ischemic neuropathy, occlusion of retinal vessels, taking medications, having a neurotoxic effect, within the last year; head and neck injuries, cardiovascular diseases, hypertension, acute and chronic disorders cerebral circulation, atherosclerosis, meningitis or meningo-encephalitis, inflammatory and volumetric processes paranasal sinuses, profuse bleeding.

Physical examination :

external examination of the eyeball (limited mobility of the eyeball, nystagmus, exophthalmos, ptosis upper eyelid)
study of the corneal reflex - may be reduced on the affected side

Laboratory research

biochemical blood test: blood cholesterol, low-density lipoproteins, high-density lipoproteins, triglycerides; ·
coagulogram;
ELISA for the virus herpes simplex, cytomegalovirus, toxoplasmosis, brucellosis, tuberculosis, rheumatic tests (according to indications, to exclude the inflammatory process)

Instrumental studies

visometry: visual acuity can range from 0.7 to practical blindness. When the papillomacular bundle is damaged, visual acuity is significantly reduced; with minor damage to the papillomacular bundle and involvement of peripheral nerve fibers of the optic nerve in the process, visual acuity decreases slightly; when only peripheral nerve fibers are affected, it does not change. ·
refractometry: the presence of refractive errors will allow differential diagnosis with amblyopia.
Amsler test - distortion of lines, clouding of the pattern (damage to the papillomacular bundle). ·
perimetry: central scotoma (with damage to the papillomacular bundle); various forms of narrowing of the visual field (with damage to the peripheral fibers of the optic nerve); with damage to the chiasm - bitemporal hemianopsia, with damage to the optic tracts - homonymous hemianopsia. When the intracranial part of the optic nerve is damaged, hemianopia occurs in one eye.
- Kinetic perimetry for colors - narrowing the field of vision to green and red, less often to yellow and blue.
- Computer perimetry - determination of the quality and quantity of scotomas in the field of view, including 30 degrees from the point of fixation.
Dark Adaptation Study: Dark Adaptation Disorder. · study of color vision: (Rabkin tables) - disturbance of color perception (increased color thresholds), more often in the green-red part of the spectrum, less often in the yellow-blue.
tonometry: possible increase in IOP (with glaucomatous optic atrophy).
biomicroscopy: on the affected side - afferent pupillary defect: decreased direct pupillary reaction to light while maintaining the congenital pupillary reaction.
ophthalmoscopy:
- initial atrophy of the optic disc – against the background of the pink color of the optic disc, blanching appears, which subsequently becomes more intense.
- partial atrophy of the optic disc – pallor of the temporal half of the optic disc, Kestenbaum’s symptom (decrease in the number of capillaries on the optic disc from 7 or less), arteries are narrowed,
- incomplete atrophy of the optic disc – uniform blanching of the optic nerve, moderately expressed Kestenbaum’s symptom (reduction in the number of capillaries on the optic disc), arteries are narrowed,
- complete atrophy of the optic nerve – total pallor of the optic nerve, vessels are narrowed (arteries are narrowed more than veins). Kestenbaum's symptom is pronounced (reduction in the number of capillaries on the optic disc - up to 2-3 or capillaries may be absent).

With primary atrophy of the optic disc, the boundaries of the optic disc are clear, its color is white, grayish-white, bluish or slightly greenish. In red-free light, the contours remain clear, whereas the contours of the optic disc normally become blurred. In red light, with atrophy of the optic disc disc, it is blue. With secondary atrophy of the optic disc, the boundaries of the optic disc are unclear, blurred, the optic disc is gray or dirty gray, the vascular infundibulum is filled with connective or glial tissue (in the long term, the boundaries of the optic disc become clear).

optical coherence tomography of the optic disc (in four segments - temporal, superior, nasal and inferior): reduction in the area and volume of the neuroretinal rim of the optic disc, reduction in the thickness of the layer of nerve fibers of the optic disc and in the macula.
Heidelberg retinal laser tomography – decreasing the depth of the optic nerve head, the area and volume of the neuroretinal belt, increasing the excavation area. In case of partial atrophy of the optic nerve, the depth range of the optic nerve head is less than 0.52 mm, the rim area is less than 1.28 mm 2, the excavation area is more than 0.16 mm 2.
fluorescein angiography of the fundus: hypofluorescence of the optic nerve head, narrowing of the arteries, absence or decrease in the number of capillaries on the optic disc;
electrophysiological studies (visual evoked potentials) - decreased VEP amplitude and prolonged latency. When the papillomacular and axial bundles of the optic nerve are damaged, electrical sensitivity is normal; when peripheral fibers are damaged, the electrical phosphene threshold is sharply increased. Lability decreases especially sharply with axial lesions. During the period of progression of the atrophic process in the optic nerve, the retino-cortical and cortical time increases significantly;
Doppler ultrasound of blood vessels head, neck, eyes: decreased blood flow in the orbital, supratrochlear artery and intracranial part of the internal carotid artery;
MRI of brain vessels: foci of demyelination, intracranial pathology (tumors, abscesses, brain cysts, hematomas);
MRI of the orbit: compression of the orbital part of the optic nerve;
X-ray of the orbit according to Riese - a violation of the integrity of the optic nerve.

Differential diagnosis

The degree of decrease in visual acuity and the nature of visual field defects are determined by the nature of the process that caused the atrophy. Visual acuity can range from 0.7 to practical blindness.

Optic atrophy with tabes develops in both eyes, but the extent of damage to each eye may not be the same. Visual acuity decreases gradually, but because... The process with tabes is always progressive, then ultimately bilateral blindness occurs at different times (from 2-3 weeks to 2-3 years). The most common form of change in the visual field in tabetic atrophy is a gradually progressive narrowing of the boundaries in the absence of scotomas within the remaining areas. Rarely, with tabesa, bitemporal scotomas, bitemporal narrowing of the boundaries of the visual field, as well as central scotomas are observed. The prognosis for tabetic optic atrophy is always poor.

Optic nerve atrophy can be observed with deformations and diseases of the skull bones. Such atrophy is observed with a tower-shaped skull. Decreased vision usually develops in early childhood and rarely after 7 years. Blindness in both eyes is rare; blindness in one eye is sometimes observed. sharp decline vision in the other eye. From the side of the visual field, there is a significant narrowing of the boundaries of the visual field along all meridians; there is no scotoma. Atrophy of the optic nerve with a tower-shaped skull is considered by most to be a consequence of congestive nipples, developing due to increased intracranial pressure. Among other deformations of the skull, atrophy of the optic nerves is caused by dysostosis craniofacialis (Crouzon's disease, Apert's syndrome, marble disease, etc.).

Optic nerve atrophy can occur due to poisoning with quinine, plasmacide, fern when expelling worms, lead, carbon disulfide, botulism, poisoning methyl alcohol. Methyl alcohol optic atrophy is not so rare. After drinking methyl alcohol, within a few hours paralysis of accommodation and dilation of the pupils appears, central scotoma occurs, and vision sharply decreases. Then vision is partially restored, but atrophy of the optic nerve gradually increases and irreversible blindness occurs.

Optic nerve atrophy can be congenital and hereditary, due to birth or postpartum head injuries, prolonged hypoxia, etc.

Diagnosis	Rationale for differential diagnosis	Surveys	Diagnosis exclusion criteria
Amblyopia	Significant decrease in vision in the absence of pathology from the anterior segment of the eye and retina.	Physical examinations	A small child has strabismus, nystagmus, and the inability to clearly fix his gaze on a bright object. In older children - decreased visual acuity and lack of improvement from its correction, impaired orientation in an unfamiliar place, squint, the habit of closing one eye when looking at an object or reading, tilting or turning the head when looking at an object of interest.
		Refractometry	Anisometropic amblyopia develops with uncorrected high degree anisometropia in the eye with more pronounced refractive errors (myopia more than 8.0 diopters, hyperopia more than 5.0 diopters, astigmatism more than 2.5 diopters in any meridian), refractive amblyopia - with a long-term absence of optical correction of hypermetropia , myopia or astigmatism with a difference in refraction of both eyes: hyperopia more than 0.5 diopters, myopia more than 2.0 diopters, astigmatic 1.5 diopters.
		HRT OCT	According to NRT: the depth range of the optic nerve head is more than 0.64 mm, the area of the optic nerve rim is more than 1.48 mm 2, the excavation area of the optic nerve is less than 0.12 mm 2.
Leber's hereditary atrophy	A sharp decrease in vision in both eyes in the absence of pathology from the anterior segment of the eye and retina.	Complaints and anamnesis	The disease develops in male members of the same family aged 13 to 28 years. Girls get sick very rarely and only if the mother is a proband and the father suffers from this disease. Heredity is associated with the X chromosome. A sharp decrease in vision in both eyes over several days. The general condition is good, sometimes patients complain of headache.
		Ophthalmoscopy	Initially, hyperemia and slight blurring of the optic disc borders appear. Gradually, the optic discs become waxy and pale, especially in the temporal half.
		Perimetry	In the field of view there is a central absolute scotoma on White color, peripheral boundaries are normal.
Hysterical amblyopia (amaurosis)	Sudden deterioration of vision or complete blindness in the absence of pathology from the anterior segment of the eye and retina.	Complaints and anamnesis	Hysterical amblyopia in adults is a sudden deterioration of vision that lasts from several hours to several months, developing against the background of severe emotional shocks. It is more often observed in women aged 16-25 years.
		Physical examinations	There may be a complete lack of reaction of the pupils to light.
		Visometry	Reduced visual acuity to varying degrees, up to blindness. With repeated studies, the data may be completely different from previous ones.
		Ophthalmoscopy	The optic disc is pale pink, the contours are clear, the Kestenbaum sign is absent.
		Perimetry	Concentric narrowing of the visual field, characteristic disturbance normal type borders - the widest field of vision for red; less commonly, hemianopsia (homonymous or heteronymous).
		VEP	VEP data is normal.
Optic nerve hypoplasia	Bilateral decrease or complete loss of vision in the absence of pathology from the anterior segment of the eye and retina.	Visometry	Optic nerve hypoplasia is accompanied by bilateral vision loss (in 80% of cases from moderate to complete blindness).
		Physical examinations	The afferent pupillary reflex is absent. Unilateral optic disc changes are often associated with strabismus and can be seen by a relative afferent pupillary defect and unilateral weak or absent fixation (instead of positional nystagmus).
		Ophthalmoscopy	The optic disc is reduced in size, pale, surrounded by a faint pigment ring. The outer ring (about the size of a normal disc) consists of the lamina cribrosa, pigmented sclera and choroid. Options: yellow-white, small disc with a double ring or complete absence of nerve and vascular aplasia. With a bilateral process, the disc is often difficult to detect; in this case, it is determined along the course of the vessels.
		Perimetry	If central vision is preserved, defects in the visual fields may be detected.
		Consultation with a neurologist, endocrinologist, laboratory tests	Optical hypoplasia of the nerve is rarely combined with septo-optic dysplasia (Morsier syndrome: absence of the transparent septum (septum pellucidum) and pituitary gland, which is accompanied by disorders of the thyroid gland and other hormonal disorders: growth retardation, attacks of hypoglycemia, combination with slowdown are possible mental development and malformations of brain structures).
Coloboma of the optic nerve head	Pathology of the optic nerve	Ophthalmoscopy	With ophthalmoscopy, the optic disc is enlarged in size (elongation of the vertical size), deep excavation or local excavation and increased crescent-shaped pigmentation with partial involvement of the lower nasal part of the optic disc in the process. When the choroid is also involved in the process, a line of demarcation appears, represented by bare sclera. Lumps of pigment may mask the boundary between normal tissue and coloboma. There may be glial tissue on the surface of the optic disc.
Coloboma of the optic nerve head	Pathology of the optic nerve	MRI	MRI - the membranes of the optic canal are weakly expressed or absent.
Morning glow syndrome	Pathology of the optic nerve	Physical examinations	Almost all patients with unilateral pathology have strabismus and high myopia in the affected eye.
		Visometry	Visual acuity is often reduced, but can also be very high.
		Refractometry	Often with a unilateral process there is high myopia of the affected eye.
		Ophthalmoscopy	On ophthalmoscopy, the optic disc is enlarged and is located as if in a funnel-shaped cavity. Sometimes the head of the optic disc is raised; it is also possible to change the position of the head of the optic disc from a staphylomatous depression to its prominence; Around the nerve there are areas of transparent grayish retinal dysplasia and pigment clumps. The demarcation line between the optic disc tissue and the normal retina is indistinguishable. Many abnormally branching vessels are identified. Most patients have areas of local retinal detachment and radial retinal folds within the excavation.
		Perimetry	Possible defects in the visual field: central scotomas and enlargement of the blind spot.
		Consultations with an otolaryngologist	Morning glow syndrome occurs as an independent manifestation or can be combined with hypertelorism, cleft lip, palate and other anomalies.

Treatment

Treatment of optic nerve atrophies is a very difficult task. In addition to pathogenetic therapy, tissue therapy, vitamin therapy, spinal puncture in combination with osmotherapy, vasodilators, B vitamins, especially B1 and B12, are used. Currently, magnetic, laser and electrical stimulation are widely used.

In the treatment of partial optic nerve atrophy, pharmacotherapy is usually used. The use of drugs makes it possible to influence various parts of the pathogenesis of optic nerve atrophy. But do not forget about physical therapy methods and various routes of drug administration. The issue of optimizing routes of drug administration has also become relevant in recent years. Thus, parenteral (intravenous) administration of vasodilators can promote systemic vasodilation, which, in some cases, can lead to steal syndrome and impair blood circulation in the eyeball. It is generally accepted that the therapeutic effect is greater when drugs are used topically. However, in diseases of the optic nerve local application medication is associated with certain difficulties caused by the existence of a number of tissue barriers. Creation of therapeutic concentration medicinal product in a pathological focus is achieved more successfully with a combination of drug therapy and physical therapy.

Drug treatment (depending on the severity of the disease)
Conservative (neuroprotective) treatment is aimed at increasing blood circulation and improving the trophism of the optic nerve, stimulating vitally active nerve fibers that have survived and/or are in the stage of apoptosis.
Drug treatment includes direct neuroprotective drugs (directly protect the retinal ganglia and axons) and indirect (reduce the effect of factors causing death nerve cells) actions.

Retinoprotectors: ascorbic acid 5% 2 ml intramuscularly once a day for 10 days, in order to reduce the permeability of the vascular wall and stabilize endothelial cell membranes
Antioxidants: tocopherol 100 IU 3 times a day – 10 days, in order to improve oxygen supply to tissues, collateral circulation, strengthen the vascular wall
Drugs that improve metabolic processes (direct neuroprotectors): retinalamin for intramuscular 1.0 ml and/or parabulbar administration 5 mg 0.5 ml parabulbar once a day for 10 days
List of additional medicines:
- vinpocetine – adults 5-10 mg 3 times a day for 2 months. Has vasodilating, antihypoxic and antiplatelet effects
- cyanocobalamin 1 ml intramuscularly once a day for 5/10 days

Electrical stimulation is also used - it is aimed at restoring the function of nerve elements that were functional, but did not perform visual information; the formation of a focus of persistent excitability, which leads to the restoration of the activity of nerve cells and their connections, which were previously weakly functioning; improvement of metabolic processes and blood circulation, which contributes to the restoration of the myelin sheath around the axial cylinders of the optic nerve fibers and, accordingly, leads to an acceleration of the action potential and the revival of the analysis of visual information.

Indications for consultation with specialists:

consultation with a therapist - to assess the general condition of the body;
consultation with a cardiologist – high level blood pressure is one of the main risk factors for the development of occlusions of the retinal and optic nerve vessels;
consultation with a neurologist - to exclude demyelinating disease of the central nervous system and clarify the topical zone of damage to the visual pathways;
consultation with a neurosurgeon - if the patient develops signs of intracranial hypertension or symptoms characteristic of a brain space-occupying lesion;
consultation with a rheumatologist - if there are symptoms characteristic of systemic vasculitis;
consultation with a vascular surgeon to decide on the need for surgical treatment if there are signs of an occlusive process in the system of the internal carotid and orbital arteries (the appearance of scotoma fugax in the patient);
consultation with an endocrinologist – in the presence of diabetes mellitus/other pathology endocrine system;
consultation with a hematologist (if blood diseases are suspected);
consultation with an infectious disease specialist (if vasculitis of viral etiology is suspected).
consultation with an otolaryngologist - if inflammation or neoplasm is suspected in the maxillary or frontal sinus.

Indicators of treatment effectiveness:

an increase in the electrical sensitivity of the optic nerve by 2-5% (according to computer perimetry),
increase in amplitude and/or decrease in latency by 5% (according to VEP data).

Anatomically and functionally, the organ of vision is not limited to the eyes. With the help of their structures, signals are perceived, and the image itself is formed in the brain. The connection between the perceptive part (retina) and the visual nuclei in the brain is carried out through the optic nerves.

Accordingly, atrophy of the optic nerve is the basis for the loss of normal vision.

Anatomy

On the side of the eyeball, the formation of nerve fibers occurs from long processes of retinal ganglion cells. Their axons intertwine at a place called the optic disc (ONH), located at the posterior pole of the eyeball a few millimeters closer to the center. The nerve fibers are accompanied by the central retinal artery and vein, which together move through the optic canal into the interior of the skull.

Functions

The main function of the nerve is to conduct signals from retinal receptors, which are processed in the cortex occipital lobes brain.

A feature of the structure of the human visual analyzer is the presence of the optic chiasm - a place where the nerves from the right and left eyes are partially intertwined with their parts closest to the center.

Thus, part of the image from the nasal region of the retina is translated to the opposite region in the brain, and from the temporal region it is processed by the hemisphere of the same name. As a result of combining images, the right visual fields are processed in the visual area of the left hemisphere, and the left ones - in the right.

Damage to the optic nerves always affects the visual field

Determination of ongoing processes

Degeneration can occur along the entire length of the nerve, at the decussation and further along the optic tracts. This type of damage is called primary atrophy; the optic disc becomes pale or silvery-white in color, but retains its original size and shape.

The causes of optic nerve atrophy lie in the formation of optic disc edema from increased intracranial pressure, impaired evacuation of venous blood and lymph. The formation of congestion is accompanied by blurring of the disc boundaries, an increase in size, and protrusion into the vitreous body. The arterial vessels of the retina are narrowed, and the venous ones become dilated and tortuous.

Prolonged stagnation leads to atrophy of the optic disc. It decreases sharply, the boundaries become clearer, the color is still pale. This is how secondary atrophy is formed. It is noteworthy that in the state of a stagnant disc, vision is still preserved, but during the transition to atrophy it sharply decreases.

Acquired dystrophy

Acquired nerve atrophies have an intraocular or descending cause.

Eye diseases include intraocular hypertension, spasm of supply vessels, their atherosclerosis, microthrombosis, consequences of hypertension, toxic damage from methyl alcohol, ethambutol, quinine.

In addition, compression of the optic disc is possible in the presence of a tumor, hematoma in the eye, or its edema. This may be caused by poisoning chemicals, eye injury, infectious abscess in the area where the optic nerve exits.

Among the inflammatory causes, I most often name iritis and cyclitis. Catarrh of the iris and ciliary body is accompanied by changes in intraocular pressure and the structure of the vitreous body, thereby affecting the state of the optic disc.

Descending optic atrophy is caused by inflammatory diseases meninges(meningitis, arachnoencephalitis), neurological lesions brain (demyelinating diseases, multiple sclerosis, consequences of infectious diseases or damage to toxins, hydrocephalus).

Atrophy can develop from compression by a tumor, hematoma, abscess along the nerve outside the eye, its inflammatory disease - neuritis

Congenital optic atrophy

The process of atrophy begins even before the birth of the child. It is caused by the presence of intrauterine diseases of the central nervous system or is hereditary.

Optic nerve atrophy in children, inherited in a dominant manner, affecting both eyes, is more common than others and is called juvenile atrophy. Violations appear by the age of 20.

Infantile congenital dystrophy is inherited as a recessive trait. It appears in newborns in the first few years of life. This is a complete permanent atrophy of the optic nerves of both eyes, which leads to a sharp decrease in vision and a concentric narrowing of the fields.

Sex-linked and complicated Beer's atrophy also appears early (before three years of age). In this case, vision suddenly decreases, after which the disease constantly progresses. With partial atrophy of the optic nerve, the outer halves of the disc are the first to be affected, then complete atrophy occurs in combination with other neurological manifestations - strabismus and nystagmus. In this case, the peripheral field of vision may be preserved, but the central one may be absent.

Leber optic atrophy usually shows its first ocular signs starting at the age of five. It begins suddenly and acutely, in many ways reminiscent of neuritis that develops in one eye, and after a month to six months, in the second.

Features:

nyctalopia – twilight vision better than daytime;
insufficiency of color vision in red and green colors;
hyperemia of the fundus, the boundaries of the disc are slightly blurred;
loss of the central visual field with preservation of the peripheral ones.

With atrophy, changes appear a couple of months after the onset of the disease. First of all, the optic optic disc suffers from the temporal region, then optic nerve atrophy develops.

Congenital atrophy can also include optodiabetic syndrome - damage to the optic disc on the background of diabetes mellitus or diabetes insipidus in combination with hydronephrosis, defects genitourinary system, deafness.

Symptoms

Typically, atrophy is accompanied by a progressive deterioration in visual function.
Scotoma is an area of blindness in the visual field that is not associated with a physiological blind spot. Usually it is surrounded by a field with normal acuity and preservation of all light-sensitive cells.
The ability to perceive colors is impaired.
In this case, partial atrophy of the optic nerve can occur with preservation of visual acuity.
With a descending path of development due to a brain tumor, specific symptoms of atrophy may be observed - Foster-Kennedy syndrome. On the part of the tumor, primary atrophy of the optic nerve head occurs and nerve atrophy occurs as a secondary phenomenon in the opposite eye.

Consequences of atrophy

Impaired conduction of visual signals due to complete atrophy of the optic nerve leads to absolute blindness in the corresponding eye. In this case, the reflex adaptation of the pupil to light is lost. It is able to react only in concert with the pupil of a healthy eye, which is tested by directed light.

Partial atrophy of the optic nerve will be reflected in sector-by-sector loss of vision in the form of separate islands.

Do not confuse the concepts of subatrophy of the optic nerve and subatrophy of the eyeball. In the latter case, the entire organ sharply decreases in size, shrinks and does not imply the function of vision at all. Such an eye must be removed surgically. The operation is necessary both to improve the patient’s appearance and to remove from the body a body that is now foreign to it, which can become a target for autoimmune reactions and cause an immune attack on the healthy eye. Atrophy of the eyeball is the irreversible loss of the organ of vision.

In the case of nerve subatrophy, it implies partial dysfunction and the possibility of conservative treatment, but without restoration of visual acuity

Damage to the optic nerve at the chiasm causes complete bilateral blindness and leads to disability.

Treatment

Many hope to cure optic nerve atrophy by looking for “miracle” traditional methods. I would like to draw attention to the fact that this condition is also official medicine considered difficult to treat. Treatment of optic nerve atrophy with folk remedies will most likely have a general strengthening and supportive effect. Decoctions of herbs, flowers, and fruits are unable to restore atrophied nerve fiber, but can be sources of vitamins, microelements, and antioxidants.

an infusion of pine needles, rose hips and onion peels, prepared from a liter of water and plant materials in a ratio of 5:2:2.
infusion of forest mallow and burdock with the addition of primrose, lemon balm and dolnik.
infusion of rue herb, unripe pine cones, lemon, prepared in a sugar solution - 0.5 cups of sand per 2.5 liters of water.

Modern methods of treating this condition are based on a complex therapeutic measures.

Drug treatment

First of all, efforts are made to restore blood circulation and nutrition to the nerve, stimulating its viable part. Vasodilators, anti-sclerotic drugs and medications that improve microcirculation, multivitamins and biostimulants are prescribed.

A breakthrough in the treatment of optic atrophy is associated with the use of nanotechnology, which involves delivering a drug directly to the nerve with nanoparticles.

Traditionally, most drugs are administered as an injection under the conjunctiva or retrobulbar - A; irrigation system – B

The prognosis for treatment of partial optic nerve atrophy in children is most favorable, since the organs are still in the process of growth and development. Irrigation therapy has a good effect. A catheter is installed in the retrobulbar space, through which the drug can be administered regularly and many times without damaging the child’s psyche.

Irreversible changes in nerve fibers prevent vision from being fully restored, so achieving a reduction in the area of death is also a success.

Treatment of secondary optic nerve atrophy will bear fruit with simultaneous treatment of the underlying disease.

Physiotherapy

Along with medications, physiotherapeutic methods can also significantly improve the condition of the nerve fiber, normalize metabolic processes and blood supply.

Today, treatment methods using magnetic, electrical, and laser stimulation of the optic nerve are known; ultrasound pulses and oxygen therapy can also be used. Forced stimulation of the nerve helps to initiate normal processes of excitation and conduction, but with a large amount of atrophy, the nerve tissue is not restored.

Surgical intervention

This type of treatment can be considered in the context of removing a tumor or other formation that is compressing the optic nerve.

On the other hand, microsurgical restoration of the nerve fiber itself is gaining increasing popularity.

The newest methods include stem cell treatment. They can be embedded in damaged tissue and further stimulate its repair by secreting neurotrophic and other growth factors.

Regeneration of nerve tissue occurs extremely rarely. The speed of recovery is critical in maintaining its functionality, so it is important to seek timely treatment. medical assistance if you suspect optic nerve atrophy, so as not to lose your vision.

This condition is the final stage of damage to the optic nerve. This is not a disease, but rather a sign of a more serious disease. Possible causes include direct trauma, pressure on the optic nerve or toxic damage, and nutritional deficiencies.

Causes of optic nerve atrophy

The optic nerve is made up of nerve fibers that transmit impulses from the eye to the brain. It contains approximately 1.2 million axons that originate in retinal cells. These axons have a thick myelin sheath and cannot regenerate after injury.

If fibers in any part of the optic nerve degenerate, its ability to transmit signals to the brain is impaired.

Regarding the causes of ASD, scientific studies have found that:

Approximately 2/3 of cases were bilateral.
The most common cause of bilateral ADN is intracranial neoplasms.
The most common cause of unilateral damage is traumatic brain injury.
Vascular factors are a common cause of AD after the age of 40 years.

In children, causes of ADN include congenital, inflammatory, infectious, traumatic and vascular factors, including perinatal strokes, mass lesions and hypoxic encephalopathy.

Let's look at the most common causes of ASD:

Primary diseases affecting the optic nerve: chronic glaucoma, retrobulbar neuritis, traumatic optic neuropathy, formations compressing the optic nerve (for example, tumors, aneurysms).
Primary retinal diseases, such as occlusion of the central retinal artery or central vein.
Secondary diseases of the optic nerve: ischemic optic neuropathy, chronic neuritis or papilledema.

Less common causes of ASD:

Hereditary optic neuropathy (eg, Leber optic neuropathy).
Toxic neuropathy, which can be caused by exposure to methanol, certain drugs (disulfiram, ethambutol, isoniazid, chloramphenicol, vincristine, cyclosporine and cimetidine), alcohol and tobacco abuse, metabolic disorders (eg, severe renal failure).
Retinal degeneration (eg, retinitis pigmentosa).
Retinal storage diseases (eg, Tay-Sachs disease)
Radiation neuropathy.
Syphilis.

Classification of optic nerve atrophy

There are several classifications of ADS.

By pathological classification There are ascending (anterograde) and descending (retrograde) optic atrophy.

The ascending ADS looks like this:

In diseases with anterograde degeneration (for example, toxic retinopathy, chronic glaucoma), the atrophy process begins in the retina and spreads towards the brain.
The rate of degeneration is determined by the thickness of the axons. Larger axons decay faster than smaller ones.

Descending optic atrophy is characterized by the fact that the atrophy process begins in the proximal part of the axon and spreads towards the optic nerve head.

According to ophthalmoscopic classification there are:

Primary ADS. In diseases with primary atrophy (for example, pituitary tumor, optic nerve tumor, traumatic neuropathy, multiple sclerosis), degeneration of optic nerve fibers leads to their replacement by columns of glial cells. With ophthalmoscopy, the optic disc is white and has clear edges, and blood vessels retinas are normal.
Secondary ADS. In diseases with secondary atrophy (eg, papilledema or inflammation of the optic disc), degeneration of nerve fibers is secondary to papilledema. On ophthalmoscopy, the optic disc has a gray or dirty gray color, its edges are unclear; retinal blood vessels may be altered.
Sequential ADS. With this form of atrophy (for example, with retinitis pigmentosa, myopia, central retinal artery occlusion), the disc has a waxy pale color with clear edges.
Glaucomatous atrophy is characterized by a cup-shaped optic disc.
Temporary optic disc pallor can occur with traumatic neuropathy or nutritional deficiencies, and is most common in patients with multiple sclerosis. The disc is pale in color with clear edges and normal vessels.

According to the degree of damage to nerve fibers, they are distinguished:

Partial atrophy of the optic nerve - the process of degeneration affects not all fibers, but a certain part of them. This form of optic nerve subatrophy is characterized by incomplete loss of vision.
Complete atrophy of the optic nerve - the degeneration process affects all nerve fibers, leading to blindness.

Symptoms of optic atrophy

The main symptom of optic atrophy is blurred vision. The clinical picture depends on the cause and severity of the pathology. For example, with partial atrophy of the optic nerves of both eyes, bilateral symptoms deterioration of vision without its complete loss, manifested first by loss of clarity and impaired color vision. When the optic nerves are compressed by the tumor, the visual field may decrease. If partial optic atrophy is left untreated, visual impairment often progresses to complete loss.

Depending on the etiological factors, patients with AD may also exhibit other symptoms that are not directly related to this pathology. For example, with glaucoma, a person may suffer from eye pain.

Characterizing the clinical picture of ADN is important in determining the cause of neuropathy. Rapid onset is characteristic of neuritis, ischemic, inflammatory and traumatic neuropathy. Gradual progression over several months is characteristic of toxic neuropathy and atrophy due to nutritional deficiencies. Even slower (over several years) pathological process develops with compressive and hereditary ADN.

If a young patient complains of pain in the eyes associated with their movement, the presence neurological symptoms(eg, paresthesia, ataxia, limb weakness), this may indicate the presence of demyelinating diseases.

In older adults with signs of ADN, the presence of temporary vision loss, double vision (diplopia), fatigue, weight loss, and muscle pain may suggest ischemic neuropathy due to giant cell arteritis.

In children, the presence of flu-like symptoms in the recent past or recent vaccination indicates parainfectious or post-vaccination optic neuritis.

Diplopia and facial pain suggest multiple neuropathy of the cranial nerves, observed with inflammatory or neoplastic lesions of the posterior orbit and the anatomical area around the sella turcica.

Short-term blurred vision, diplopia and headaches indicate the possibility of increased intracranial pressure.

Diagnosis of optic nerve atrophy

Described clinical picture can be observed not only with ADN, but also with other diseases. To establish the correct diagnosis, if vision problems occur, you need to consult an ophthalmologist. He will perform a comprehensive eye examination, including an ophthalmoscopy, which can be used to examine the optic nerve head. With atrophy, this disc has a pale color, which is associated with a change in blood flow in its vessels.

To confirm the diagnosis, you can perform optical coherence tomography, an examination of the eyeball that uses infrared light waves for visualization. The ophthalmologist also evaluates color vision, the reaction of the pupils to light, determines the acuity and impairment of visual fields and measures intraocular pressure.

It is very important to determine the cause of ADN. For this purpose, the patient may undergo computed or magnetic resonance imaging of the orbits and brain, laboratory testing for the presence of genetic abnormalities, or a diagnosis of toxic neuropathy.

How to treat optic nerve atrophy?

How to treat optic nerve atrophy? The importance of vision for a person cannot be overestimated. Therefore, if you have any symptoms of optic nerve atrophy, you should under no circumstances resort to treatment with folk remedies on your own; you should immediately contact a qualified ophthalmologist.

It is necessary to begin treatment at the stage of partial atrophy of the optic nerve, which allows many patients to retain some vision and reduce the degree of disability. Unfortunately, with complete degeneration of nerve fibers, it is almost impossible to restore vision.

The choice of treatment depends on the cause of the disorder, for example:

Treatment of descending optic atrophy caused by an intracranial tumor or hydrocephalus is aimed at eliminating compression of the nerve fibers by the tumor.
When inflammatory diseases optic nerve (neuritis) or ischemic neuropathy is used intravenous administration corticosteroids.
For toxic neuropathy, antidotes are prescribed to those substances that caused damage to the optic nerves. If atrophy is caused by drugs, their use is stopped or the dose is adjusted.
Neuropathy due to nutritional deficiencies is treated by adjusting the diet and prescribing multivitamins that contain microelements necessary for good vision.
With glaucoma it is possible conservative treatment, aimed at reducing intraocular pressure, or performing surgery.

In addition, there are methods of physiotherapeutic, magnetic, laser and electrical stimulation of the optic nerve, which are aimed at preserving the functions of the nerve fibers as much as possible.

There are also scientific works, which showed the effectiveness of treating ADN using the introduction of stem cells. Using this still experimental technique, it is possible to partially restore vision.

Prognosis for ADN

The optic nerve is part of the central, not the peripheral, nervous system, which makes it impossible to regenerate after damage. Thus, ADN is irreversible. Treatment of this pathology is aimed at slowing down and limiting the progression of the degeneration process. Therefore, every patient with optic nerve atrophy should remember that the only place where this pathology can be cured or its development stopped is the ophthalmology departments in medical institutions.

The prognosis for vision and life with AD depends on the cause of it and the degree of damage to the nerve fibers. For example, with neuritis, after the inflammatory process subsides, vision may improve.

Prevention

In some cases, the development and progression of ADN can be prevented by proper treatment of glaucoma, toxic, alcohol and tobacco neuropathy, and eating a nutritious and nutrient-rich diet.

Optic nerve atrophy is a consequence of degeneration of its fibers. It can be caused by many diseases, from glaucoma and blood supply disorders (ischemic neuropathy) to inflammatory processes (for example, multiple sclerosis) and formations that compress the nerve (for example, intracranial tumors). Effective treatment is possible only at the stage of partial atrophy of the optic nerve. The choice of treatment method depends on etiological factors. In this regard, it is necessary to establish the correct diagnosis in time and direct all efforts to preserve vision.