Atrophy optic nerve consists in the development of a pathology in which the optic nerve is partially or completely subject to destruction within its own fibers, after which these fibers are subject to replacement by connective tissue. Optic nerve atrophy, the symptoms of which are decreased visual functions in combination with general blanching of the nerve disc, may be congenital or acquired in nature.
general description
In ophthalmology, diseases of the optic nerve of one type or another are diagnosed on average in 1-1.5% of cases, while in approximately 26% of them the optic nerve is subject to complete atrophy, which, in turn, causes blindness that cannot be treated. cure. In general, with atrophy, as is clear from the description of the consequences to which it leads, there is a gradual death of its fibers in the optic nerve, followed by their gradual replacement, ensured by connective tissue. This is also accompanied by the conversion of the light signal received by the retina into an electrical signal during its further transmission to the posterior lobes of the brain. Against this background, they are developing various types disorders, with a narrowing of the visual fields and a decrease in visual acuity preceding blindness.
Optic nerve atrophy: causes
Congenital or hereditary pathologies directly related to vision that are relevant to the patient can be considered as reasons that provoke the development of the disease we are considering. Optic nerve atrophy can also develop as a result of suffering from any eye diseases or a certain type of pathological process that affects the retina and the optic nerve itself. Examples of the latter factors include eye injury, inflammation, dystrophy, congestion, edema, damage caused by toxic effects, compression of the optic nerve, circulatory disorders of one scale or another. In addition, current pathologies affecting nervous system, and general type diseases.
In frequent cases, the development of optic nerve atrophy is caused by the influence exerted by the pathology of the central nervous system that is relevant to the patient. Such pathologies can be considered syphilitic brain damage, abscesses and brain tumors, meningitis and encephalitis, trauma to the skull, multiple sclerosis etc. Alcohol poisoning caused by drinking methyl alcohol, and general intoxications of the body are also among the factors affecting the central nervous system, and, ultimately, among the factors provoking optic nerve atrophy.
The development of the pathology we are considering can also be contributed to by diseases such as atherosclerosis and hypertension, as well as conditions the development of which is provoked by vitamin deficiency, quinine poisoning, profuse bleeding and fasting.
In addition to the listed factors, optic nerve atrophy can also develop against the background of obstruction of the peripheral retinal arteries and obstruction of the central artery in it. Due to these arteries, nutrition of the optic nerve is provided; accordingly, if they are obstructed, its functions are disrupted and general state. It should be noted that obstruction of these arteries is also considered as the main symptom indicating the manifestation of glaucoma.
Optic nerve atrophy: classification
Optic nerve atrophy, as we initially noted, can manifest itself both as a hereditary pathology and as a non-hereditary pathology, that is, acquired. Hereditary form of this disease can manifest itself in such basic forms as the autosomal dominant form of optic atrophy, the autosomal recessive form of optic atrophy, as well as the mitochondrial form.
The congenital form of atrophy is considered as atrophy resulting from genetic diseases, due to which the patient has visual impairment since birth. Leber's disease is identified as the most common disease in this group.
As for the acquired form of optic nerve atrophy, it is determined by the peculiarities of the influence of etiological factors, such as damage to the fibrous structure of the optic nerve (which determines such a pathology as descending atrophy) or damage to retinal cells (this, accordingly, determines such a pathology as ascending atrophy) atrophy). The acquired form of optic nerve atrophy can, again, be provoked by inflammation, glaucoma, myopia, metabolic disorders in the body and other factors that we have already discussed above. Acquired optic atrophy can be primary, secondary or glaucomatous.
At the heart of the mechanism primary form of atrophy The optic nerve is considered to be an effect in which compression of peripheral neurons within the visual pathway occurs. Primary form (which is also defined as simple form) atrophy is accompanied by clear disc boundaries and pallor, narrowing of blood vessels in the retina and possible development excavation.
Secondary atrophy, developing against the background of stagnation of the optic nerve or against the background of its inflammation, is characterized by the appearance of signs inherent in the previous, primary form of atrophy, but in this case the only difference is the vagueness of the boundaries, which is relevant for the boundaries of the optic nerve head.
At the heart of the development mechanism glaucomatous form of atrophy The optic nerve, in turn, is considered to be a collapse that has arisen in the sclera from the side of its cribriform plate, which occurs due to a state of increased intraocular pressure.
In addition, the classification of forms of optic nerve atrophy also includes such variants of this pathology as already noted in the general review partial atrophy optic nerve and complete atrophy optic nerve. Here, as the reader can roughly assume, we are talking about the specific degree of scale of damage to nerve tissue.
A characteristic feature of the partial form of optic nerve atrophy (or initial atrophy, as it is also defined) is the incomplete preservation of visual function (vision itself), which is important when visual acuity is reduced (due to which the use of lenses or glasses does not improve the quality of vision). Although residual vision can be preserved in this case, there are disturbances in color perception. Preserved areas within sight remain accessible.
In addition, optic nerve atrophy can manifest itself in stationary form ( that is, in finished form or non-progressive form), which indicates a stable state of actual visual functions, as well as in the opposite, progressive form, in which a decrease in the quality of visual acuity inevitably occurs. Depending on the extent of the lesion, optic nerve atrophy manifests itself in both unilateral and bilateral forms (that is, affecting one eye or both eyes at once).
Optic nerve atrophy: symptoms
The main symptom of this disease is, as noted earlier, a decrease in visual acuity, and this pathology not amenable to any correction. The manifestations of this symptom may vary depending on the specific type of atrophy. Progression of the disease can lead to a gradual decrease in vision until complete atrophy is achieved, in which vision is completely lost. The duration of this process can vary from several days to several months.
Partial atrophy is accompanied by a stop in the process at a certain stage, after which vision stops falling. According to these features, a progressive or completed form of the disease is distinguished.
With atrophy, vision can be impaired in various ways. Thus, the fields of vision may change (basically they narrow, which is accompanied by the disappearance of the so-called lateral vision), which can lead to the development of a “tunnel” type of vision, in which it seems that everything is seen as if through a tube, in other words, only visibility of objects directly in front of a person. Often scotomas become a companion to this type of vision; in particular, they mean the appearance in any part of the visual field dark spots. Color vision disorder is also relevant.
Visual fields can change not only according to the type of “tunnel” vision, but also based on the specific location of the lesion. If scotomas, that is, the dark spots noted above, appear in the patient’s eyes, this indicates that those nerve fibers that are concentrated in maximum proximity to the central part of the retina or are located directly in it have been affected. The visual fields are narrowed due to damage to the nerve fibers; if the optic nerve is affected at a deeper level, then half of the visual field (nasal or temporal) may disappear. As already noted, the lesion can be either unilateral or bilateral.
Thus, we can summarize the symptoms under the following main points that determine the picture of the course:
- the appearance of sector-shaped and central scotomas (dark spots);
- decreased quality of central vision;
- concentric narrowing of the field of view;
- pallor of the optic nerve head.
Secondary optic nerve atrophy determines the following manifestations during ophthalmoscopy:
- varicose veins;
- vasoconstriction;
- smoothing the area of the optic nerve boundaries;
- disc blanching.
Diagnosis
Self-diagnosis, as well as self-medication (including treatment of optic nerve atrophy folk remedies) for the disease in question should be completely excluded. In the end, due to the similarity of the manifestations characteristic of this pathology with manifestations, for example, of a peripheral form of cataract (accompanied initially by impaired lateral vision with subsequent involvement of the central parts) or with amblyopia (a significant decrease in vision without the possibility of correction), it is necessary to establish independently accurate diagnosis It's simply impossible.
What is noteworthy is that even of the listed disease options, amblyopia is not a disease as dangerous as optic nerve atrophy can be for a patient. Additionally, it should be noted that atrophy can also manifest itself not only as an independent disease or as a result of exposure to another type of pathology, but can also act as a symptom individual diseases, including diseases ending fatal. Considering the seriousness of the defeat and everything possible complications, it is extremely important to promptly begin diagnosing optic nerve atrophy, to find out the reasons that provoked it, as well as to adequately treat it.
The main methods on which the diagnosis of optic nerve atrophy is based include:
- ophthalmoscopy;
- visometry;
- perimetry;
- color vision research method;
- CT scan;
- radiography of the skull and sella turcica;
- NMR scanning of the brain and orbit;
- fluorescein angiography.
Also, a certain information content is achieved to compile a general picture of the disease through laboratory research methods, such as blood tests (general and biochemical), testing for borelliosis or syphilis.
Treatment
Before moving on to the specifics of the treatment, we note that it in itself is an extremely difficult task, because the restoration of damaged nerve fibers is in itself impossible. A certain effect, of course, can be achieved through treatment, but only under the condition of restoration of those fibers that are in the active phase of destruction, that is, with a certain degree of their vital activity against the background of such exposure. Missing this moment can cause final and irreversible loss of vision.
Among the main areas of treatment for optic nerve atrophy, the following options can be distinguished:
- treatment is conservative;
- therapeutic treatment;
- surgical treatment.
Principles conservative treatment boil down to the sale of the following drugs in it:
- vasodilators;
- anticoagulants (heparin, ticlid);
- drugs whose effect is aimed at improving the general blood supply to the affected optic nerve (papaverine, no-spa, etc.);
- drugs that affect metabolic processes and stimulate them in the area of nerve tissue;
- drugs that stimulate metabolic processes and have a resolving effect on pathological processes; drugs that relieve inflammatory process (hormonal drugs); drugs that help improve the functions of the nervous system (nootropil, Cavinton, etc.).
Physiotherapeutic procedures include magnetic stimulation, electrical stimulation, acupuncture and laser stimulation of the affected nerve.
The repetition of the course of treatment, based on the implementation of measures in the listed areas of influence, occurs after a certain time (usually within several months).
As for surgical treatment, it implies an intervention aimed at eliminating those formations that compress the optic nerve, as well as bandaging the area temporal artery and to carry out the implantation of biogenic materials that help improve blood circulation in the atrophied nerve and its vascularization.
Cases of significant loss of vision due to the disease in question necessitate assigning the patient the appropriate degree of impairment to a disability group. Visually impaired patients, as well as patients who have completely lost their vision, are sent to a rehabilitation course aimed at eliminating the restrictions that have arisen in life, as well as compensating for them.
Let us repeat that optic nerve atrophy, which is treated using traditional medicine, has one very significant drawback: when using it, time is lost, which is practically precious as part of the progression of the disease. It is during the period of active independent implementation of such measures by the patient that there is an opportunity to achieve positive and significant results on their own scale due to more adequate treatment measures (and previous diagnostics, by the way, too); it is in this case that the treatment of atrophy is considered as an effective measure in which the return of vision is permissible . Remember that treatment of optic nerve atrophy with folk remedies determines the minimum effectiveness of the effect thus provided!
Update: December 2018
The quality of life is primarily affected by our health. Free breathing, clear hearing, freedom of movement - all this is very important for a person. Disturbance in the functioning of even one organ can lead to a change in the usual way of life. negative side. For example, forced refusal of active physical activity (running in the morning, going to the gym), eating tasty (and fatty) foods, intimate relationships etc. This manifests itself most clearly when the organ of vision is damaged.
Most eye diseases have a fairly favorable course for humans, since modern medicine is able to cure them or reduce the negative effect to nothing (correct vision, improve color perception). Complete and even partial atrophy of the optic nerve does not belong to this “majority”. With this pathology, as a rule, the functions of the eye are significantly and irreversibly impaired. Often patients lose the ability to perform even daily activities and become disabled.
Can this be prevented? Yes, you can. But only with timely detection of the cause of the disease and adequate treatment.
What is optic atrophy
This is a condition in which nerve tissue suffers from an acute deficiency nutrients, due to which it ceases to perform its functions. If the process continues long enough, the neurons begin to gradually die. Over time, it affects an increasing number of cells, and in severe cases, the entire nerve trunk. It will be almost impossible to restore eye function in such patients.
To understand how this disease manifests itself, it is necessary to imagine the course of impulses to brain structures. They are conventionally divided into two portions – lateral and medial. The first contains a “picture” of the world around him, which he sees inner side eyes (closer to the nose). The second is responsible for the perception of the outer part of the image (closer to the crown).
Both parts are formed on back wall eyes, from a group of special (ganglion) cells, after which they are sent to various brain structures. This path is quite difficult, but there is one fundamental point - almost immediately after leaving the orbit, a cross occurs in internal portions. What does this lead to?
- The left tract perceives the image of the world from the left side of the eyes;
- The right one transfers the “picture” from the right halves to the brain.
Therefore, damage to one of the nerves after it has left the orbit will result in changes in the function of both eyes.
Causes
In the vast majority of cases, this pathology does not occur independently, but is a consequence of another eye disease. It is very important to consider the cause of optic nerve atrophy, or rather the location of its occurrence. It is this factor that will determine the nature of the patient’s symptoms and the specifics of therapy.
There may be two options:
- Ascending type - the disease occurs from that part of the nerve trunk that is closer to the eye (before the chiasm);
- Descending form - the nervous tissue begins to atrophy from top to bottom (above the chiasm, but before entering the brain).
Most common reasons These conditions are presented in the table below.
| Characteristic reasons | a brief description of |
Ascending type |
|
| Glaucoma | This word hides a number of disorders that are united by one feature - increased intraocular pressure. Normally, it is necessary to maintain correct form eyes. But with glaucoma, pressure impedes the flow of nutrients to the nerve tissue and makes them atrophic. |
| Intrabulbar neuritis | An infectious process that affects neurons in the cavity of the eyeball (intrabulbar form) or behind it (retrobulbar type). |
| Retrobulbar neuritis | |
| Toxic nerve damage | Exposure to toxic substances in the body leads to the breakdown of nerve cells. The following have a damaging effect on the analyzer:
|
| Ischemic disorders | Ischemia is a lack of blood flow. May occur when:
|
| Stagnant disk | By its nature, this is swelling of the initial part of the nerve trunk. It can occur in any condition associated with increased intracranial pressure:
|
| Tumors of the nerve or surrounding tissues located before the chiasm | Pathological tissue proliferation can lead to compression of neurons. |
Descending type |
|
| Toxic lesions (less common) | In some cases, the toxic substances described above can damage neurocytes after crossing. |
| Tumors of the nerve or surrounding tissues located after the chiasm | Oncological processes are the most common and most dangerous reason descending form of the disease. They are not classified as benign, since the difficulties of treatment make it possible to call all brain tumors malignant. |
| Specific lesions of nervous tissue | In the outcome of some chronic infections which occur with the destruction of neurocytes throughout the body, the trunk of the optic nerve may partially/completely atrophy. These specific lesions include:
|
| Abscesses in the cranial cavity | After neuroinfections (meningitis, encephalitis and others), cavities limited by connective tissue walls - abscesses - may appear. If they are located next to the optic tract, there is a possibility of pathology. |
Treatment of optic atrophy is closely related to identifying the cause. Therefore, close attention should be paid to clarifying it. Symptoms of the disease, which allow one to distinguish the ascending form from the descending one, can help in diagnosis.
Symptoms
Regardless of the level of damage (above or below the intersection) reliable signs There are two types of optic nerve atrophy: loss of visual fields (“anopia”) and decreased visual acuity (amblyopia). How pronounced they will be in a particular patient depends on the severity of the process and the activity of the cause that caused the disease. Let's take a closer look at these symptoms.
Loss of visual fields (anopsia)
What does the term "field of view" mean? Essentially, this is just an area that a person sees. To imagine it, you can close half of your eye on either side. In this case, you see only half of the picture, since the analyzer cannot perceive the second part. We can say that you have “lost” one (right or left) zone. This is exactly what anopsia is - the disappearance of the field of vision.
Neurologists divide it into:
- temporal (half of the image located closer to the temple) and nasal (the other half from the side of the nose);
- right and left, depending on which side the zone falls on.
With partial atrophy of the optic nerve, there may be no symptoms, since the remaining neurons transmit information from the eye to the brain. However, if a lesion occurs through the entire thickness of the trunk, this sign will certainly appear in the patient.
Which areas will be missing from the patient’s perception? This depends on the level at which the pathological process is located and on the degree of cell damage. There are several options:
| Type of atrophy | Damage level | What does the patient feel? |
| Complete – the entire diameter of the nerve trunk is damaged (the signal is interrupted and is not transmitted to the brain) | The organ of vision on the affected side completely ceases to see | |
| Loss of right or left visual fields in both eyes | ||
| Incomplete - only part of the neurocytes do not perform their function. Most of the image is perceived by the patient | Before the cross (with an ascending form) | There may be no symptoms or the field of vision in one eye may be lost. Which one depends on the location of the atrophy process. |
| After crossing (with descending type) |
This neurological symptom It seems difficult to understand, but thanks to it, an experienced specialist can identify the location of the lesion without any additional methods. Therefore, it is very important that the patient speaks openly to their doctor about any signs of visual field loss.
Decreased visual acuity (amblyopia)
This is the second sign that is observed in all patients without exception. Only the degree of its severity varies:
- Mild – characteristic of the initial manifestations of the process. The patient does not feel a decrease in vision, the symptom appears only when carefully examining distant objects;
- Medium – occurs when a significant portion of neurons are damaged. Distant objects are practically invisible; at a short distance the patient does not experience any difficulties;
- Severe – indicates the activity of the pathology. The sharpness is reduced so much that even objects located nearby become difficult to distinguish;
- Blindness (synonymous with amorosis) is a sign of complete atrophy of the optic nerve.
As a rule, amblyopia occurs suddenly and gradually increases, without adequate treatment. If the pathological process is aggressive or the patient does not seek help in a timely manner, there is a possibility of developing irreversible blindness.
Diagnostics
As a rule, problems with detecting this pathology rarely arise. The main thing is for the patient to seek treatment in a timely manner. medical care. To confirm the diagnosis, he is referred to an ophthalmologist for a fundus examination. This is a special technique with which you can examine the initial part of the nerve trunk.
How is ophthalmoscopy performed?. In the classic version, the fundus is examined by a doctor in a dark room, using a special mirror device (ophthalmoscope) and a light source. The use of modern equipment (electronic ophthalmoscope) allows this study to be carried out with greater accuracy. The patient does not require any preparation for the procedure and special actions during the inspection.
Unfortunately, ophthalmoscopy does not always detect changes, since symptoms of damage occur earlier than tissue changes. Laboratory research(blood tests, urine tests, cerebrospinal fluid) are nonspecific and have only auxiliary diagnostic value.
How to proceed in this case? In modern multidisciplinary hospitals, to detect the cause of the disease and changes in nervous tissue, the following methods exist:
| Research method | Principle of the method | Changes in atrophy |
| Fluorescein angiography (FA) | The patient is injected with a dye through a vein, which enters the blood vessels of the eyes. Using a special device that emits light of different frequencies, the fundus of the eye is “illuminated” and its condition is assessed. | Signs of insufficient blood supply and tissue damage |
| Laser eye disc tomography (HRTIII) | Non-invasive (remote) way to study the anatomy of the fundus. | Changes in the initial part of the nerve trunk according to the type of atrophy. |
| Optical coherence tomography (OCT) of the optic nerve head | Using high-precision infrared radiation, the condition of tissues is assessed. | |
| CT/MRI of the brain | Non-invasive methods for studying the tissues of our body. Allows you to obtain an image at any level, with an accuracy of cm. | Used to find out possible reason diseases. Typically, the purpose of this study is to look for a tumor or other mass formation (abscesses, cysts, etc.). |
Treatment of the disease begins from the moment the patient contacts, since it is irrational to wait for diagnostic results. During this time, the pathology may continue to progress, and changes in tissues will become irreversible. After clarifying the cause, the doctor adjusts his tactics to achieve the optimal effect.
Treatment
There is a widespread belief in society that “nerve cells do not recover.” This is not entirely correct. Neurocytes can grow, increase the number of connections with other tissues and take on the functions of dead “comrades”. However, they do not have one property that is very important for complete regeneration - the ability to reproduce.
Can optic nerve atrophy be cured? Definitely not. At partial defeat trunk, medications can improve visual acuity and fields. In rare cases, even virtually restoring the patient's ability to see up to normal level. If the pathological process completely disrupts the transmission of impulses from the eye to the brain, only surgery can help.
For successful therapy For this disease, it is necessary, first of all, to eliminate the cause of its occurrence. This will prevent/reduce cell damage and stabilize the course of pathology. Since there are a large number of factors that cause atrophy, doctors’ tactics may differ significantly when various states. If it is not possible to cure the cause ( malignant tumor, hard-to-reach abscess, etc.), you should begin immediately to restore the functionality of the eye.
Modern methods of nerve restoration
Even 10-15 years ago the main role in the treatment of optic nerve atrophy, vitamins and angioprotectors were used. Currently, they only have additional meaning. Medicines that restore metabolism in neurons (antihypoxants) and increase blood flow to them (nootropics, antiplatelet agents and others) come to the fore.
A modern scheme for restoring eye functions includes:
- Antioxidant and antihypoxant (Mexidol, Trimetazidine, Trimectal and others) - this group is aimed at tissue restoration, reducing the activity of damaging processes, and eliminating “oxygen starvation” of the nerve. In a hospital setting, they are administered intravenously; during outpatient treatment, antioxidants are taken in the form of tablets;
- Microcirculation correctors (Actovegin, Trental) - improve metabolic processes in nerve cells and increase their blood supply. These drugs are one of the most important components of treatment. Also available in the form of solutions for intravenous infusions and tablets;
- Nootropics (Piracetam, Cerebrolysin, Glutamic acid) – stimulators of blood flow of neurocytes. Accelerate their recovery;
- Drugs that reduce vascular permeability (Emoxipin) - protects the optic nerve from further damage. It was introduced into the therapy of eye diseases not so long ago and is used only in large ophthalmological centers. It is administered parabulbarly (a thin needle is passed along the wall of the orbit into surrounding the eye fiber);
- Vitamins C, PP, B 6, B 12 are an additional component of therapy. These substances are believed to improve metabolism in neurons.
The above is a classic treatment for atrophy, but in 2010, ophthalmologists proposed fundamentally new methods for restoring eye function using peptide bioregulators. At the moment, only two drugs are widely used in specialized centers - Cortexin and Retinalamin. Studies have shown that they improve vision almost twice.
Their effect is realized through two mechanisms - these bioregulators stimulate the restoration of neurocytes and limit damaging processes. The method of their application is quite specific:
- Cortexin - used as injections into the skin of the temples or intramuscularly. The first method is preferable, since it creates a higher concentration of the substance;
- Retinalamin - the medicine is injected into the parabulbar tissue.
The combination of classical and peptide therapy is quite effective for nerve regeneration, but even this does not always achieve the desired result. You can additionally stimulate recovery processes with the help of targeted physiotherapy.
Physiotherapy for optic atrophy
There are two physiotherapeutic techniques, whose positive effects are confirmed by scientific research:
- Pulsed magnetic therapy (MPT) - this method is not aimed at restoring cells, but at improving their functioning. Thanks to the directed influence of magnetic fields, the contents of neurons are “condensed”, which is why the generation and transmission of impulses to the brain is faster;
- Bioresonance therapy (BT) – its mechanism of action is associated with the improvement of metabolic processes in damaged tissues and normalization of blood flow through microscopic vessels (capillaries).
They are very specific and are used only in large regional or private ophthalmology centers, due to the need for expensive equipment. As a rule, for most patients these technologies are paid, so BMI and BT are used quite rarely.
Surgical treatment of atrophy
In ophthalmology, there are special operations that improve visual function in patients with atrophy. They can be divided into two main types:
- Redistributing blood flow in the eye area - in order to increase the flow of nutrients to one place, it is necessary to reduce it in other tissues. For this purpose, some of the vessels on the face are ligated, which is why most of the blood is forced to flow through the ophthalmic artery. This type of intervention is performed quite rarely, as it can lead to complications in the postoperative period;
- Transplantation of revascularizing tissues - the principle of this operation is to transplant tissues with an abundant blood supply (parts of muscle, conjunctiva) into an atrophic area. New vessels will grow through the graft, ensuring adequate blood flow to the neurons. Such an intervention is much more widespread, since it practically does not affect other tissues of the body.
Several years ago, stem cell treatment methods were actively developed in the Russian Federation. However, an amendment to the country's legislation made these studies and the use of their results on people illegal. Therefore, at present, technologies of this level can only be found abroad (Israel, Germany).
Forecast
The degree of vision loss in a patient depends on two factors - the severity of damage to the nerve trunk and the time of initiation of treatment. If the pathological process has affected only a part of the neurocytes, in some cases it is possible to almost completely restore the functions of the eye, with adequate therapy.
Unfortunately, with the atrophy of all nerve cells and the cessation of impulse transmission, there is a high probability of the patient developing blindness. The solution in this case may be surgical restoration of tissue nutrition, but such treatment does not guarantee the restoration of vision.
FAQ
Question:
Could this disease be congenital?
Yes, but very rarely. In this case, all the symptoms of the disease described above appear. As a rule, the first signs are detected before the age of one year (6-8 months). It is important to consult an ophthalmologist in a timely manner, since the greatest effect of treatment is observed in children under 5 years of age.
Question:
Where can optic nerve atrophy be treated?
It should be emphasized once again that it is impossible to completely get rid of this pathology. With the help of therapy, it is possible to control the disease and partially restore visual functions, but it cannot be cured.
Question:
How often does pathology develop in children?
No, these are quite rare cases. If a child is diagnosed and confirmed, it is necessary to clarify whether it is congenital.
Question:
What treatment with folk remedies is most effective?
Atrophy is difficult to treat even highly active drugs and specialized physiotherapy. Traditional methods will not have a significant impact on this process.
Question:
Do they provide disability groups for atrophy?
This depends on the degree of vision loss. Blindness is the indication for the first group, acuity from 0.3 to 0.1 for the second.
All therapy is accepted by the patient for life. Short-term treatment is not enough to control this disease.
Partial optic atrophy is a simpler form of atrophy that affects the fibers responsible for accurately transmitting images to the brain. As a rule, the fibers begin to die and are then replaced by connective tissue. And it, in turn, cannot replace the functions of the fibers, and therefore there is a decrease in vision and field. There are only 2 forms of optic nerve atrophy. This is partial and complete.
By complete we mean the death of the fibers completely, which inevitably leads to blindness. Unlike full form, with partial, only a small part of the fibers dies, but this is also fraught with complications. Therefore, it is extremely important to promptly detect atrophy and carry out treatment. It is worth noting that partial is manifested by a slight weakening of sharpness and a significant loss of the ability to see color shades.
Initially, you need to understand how image information is transmitted to the visual part of the brain. It turns out that when a picture is perceived, a light signal appears that passes through the retina and enters the brain through the optic nerve. It would seem that everything is simple, but the nerve has an extremely large number of fibers and each of them is responsible for a specific area. If there is a problem of dying off, then this light signal arrives in a modified form. pathological form, resulting in impaired vision.
what causes the disease
Partial optic nerve atrophy causes:
- Compression of the optic nerve by various growths or tumors.
- Retinal pathologies.
- Glaucoma.
- Inflammation in the nerve.
- Myopia.
- Brain pathologies.
- Infectious manifestations: encephalitis, brain abscess, meningitis, arachnoiditis.
- Sclerosis.
- Atherosclerosis.
- Hypertension.
- Heredity.
- Poisoning with chemicals, alcohol.
- Pathologies of the nervous system, heart and blood vessels.
- Injury.
Signs of a partial form of the disease
You need to know that usually with this disease two organs are affected simultaneously, but with varying degrees(originally). There are 4 degrees of severity of the disease. As a rule, than weaker degree, the fewer signs are expressed. As the disease progresses, the symptoms intensify and become aggravated. So, partial atrophy of the optic nerves of both eyes symptoms:
- Reduced visibility.
- When moving the eyes, the patient experiences pain.
- Disappearance of lateral vision due to narrowing of the visual field. And later it may fall out altogether.
- The appearance of dark spots in the eyes, which are characterized as blind spots.
Treatment of partial type of nerve atrophy
Unlike the full form, partial atrophy of the optic nerve can still be treated. It is aimed at stopping pathological changes in tissue directly in the optic nerve. IN in this case necessity is the preservation of what remains healthy functional form. Those fibers that have already turned into connective tissue it is almost impossible to restore, but it is also impossible without treatment. Otherwise, the pathology will progress, and this will lead to complete blindness.
As a rule, initial treatment is conservative. Drugs are selected that improve the blood supply to the nerve of the visual apparatus, accelerate metabolic processes in the entire body at the cellular level, dilate blood vessels, biostimulating drugs and multivitamins. Thanks to such medications, nutrition and saturation with useful substances are provided. visual organ, swelling of the nerve is reduced, the inflammatory process is eliminated, which leads to the stimulation of healthy fibers.
In more complex cases, or if drug therapy did not give a positive result, applied surgical method treatment. Here, first of all, the cause of the disease is eliminated, in order to avoid further development. Physiotherapy is recommended in combination with the two listed methods. It could be laser correction, electrical stimulation, exposure of the affected organ to magnetic rays, electrophoresis and even oxygen therapy.
Treatment depending on the cause
Therapy always depends on the cause of the pathology. For example:
- With partial atrophy of the optic nerve acquired due to dysfunction vascular system, vasoactive drugs are used and antioxidant agents. This can be “Sermion”, “Cavinton” and “Tanakan”, as well as “Mexidop”, “Mildronat” and “Emoxipin”.
- If the disease appears due to disorders of the nervous system, then nootropic and fermenotropic drugs are used. For example, “Actovegin”, Nootropil”, “Sopcoseryl”, “Wobenzym” and “Fpogenzym”.
- For toxic partial atrophy, not only vasoactive and nootropic drugs are used, but also detoxification and peptide drugs.
- For partial descending atrophy, bioregulatory therapy using drugs such as Cortexin and Epithalamin is indicated.
- If the disease occurs due to genetic inheritance, injury or inflammation, then cytomedins (“Cortexin” or “Retinalami”) are used.
Partial optic atrophy: Disability is assumed in the same way as in the case of complete atrophy. But in this case, group 3 is used if there is a 2nd degree of severity of the disease. In this case, there should be a weakened visualization of objects of an average degree. To obtain other disability groups, there must be indicators characteristic of complete atrophy.
How children are treated
For partial atrophy of the optic nerve in children, treatment is prescribed almost identical to adults. The goal is also to inhibit the progression and death of fibers. It is imperative to nourish the nerve and saturate it with oxygen. Drugs can be administered either by drip or by injection. Electrophoresis, oxygen therapy and ultrasound procedures are always used.
Such a serious ophthalmological disease as descending optic atrophy begins to develop in connection with degenerative processes.
Sclerotic changes occur in the fibers of nerve tissue.
As the disease progresses, vision not only deteriorates, but may even disappear completely. It's connected with the death of nerve fibers that carry information about the retinal image to the brain.
Why does descending optic atrophy occur and how to recognize it?
Illness provoke the following reasons:
- Consequences glaucoma.
- Vasoconstriction, compressing the optic nerve - a tumor appears in the cranial cavity, resulting in the formation brain abscess.
- Complications myopia.
- Development in blood vessels atherosclerotic plaques— we are talking about the vessels that supply the optic nerves with blood. Thrombosis begins, the walls become inflamed. Violation of the structure of blood vessels often contributes to syphilis, vasculitis, diabetes mellitus or hypertension.
- Injuries eyes.
- Intoxication(ARVI, use of alcohol substitutes, narcotic substances, nicotine and quinine).
When the fibers of one optic nerve pathology is considered unilateral. Atrophy in both eyes cause the following disorders and diseases:
- syphilis;
- intoxication;
- tumor in the cavities of the skull;
- blood supply disturbance(for atherosclerosis, diabetes, hypertension).
Symptoms of complete and partial atrophy
Symptoms of the disease depends on the type atrophy. The main sign of pathology is decreased visual acuity.
Important! Improve vision in case of atrophy glasses or contact lenses will not work.
Another characteristic symptom of the disease is visual field change. During the diagnosis of the disease, the patient describes in detail his feelings, according to which the doctor determines at what stage the disease is. The patient may observe the following phenomena:
- you can see everything as if through a tube - tunnel vision;
- before my eyes regularly spots appear, reminiscent of a mosaic;
- image fragment, which is located in the bow, absent, the same thing is noticed from the side of the temples.
In patients violations are observed in color vision . A person does not distinguish the color red and does not perceive green shades.
Characteristic sign illness - slow recovery of vision when leaving the dark into the light and vice versa. This symptom often appears at the beginning of the disease, after which it actively progresses.
Reference. Atrophy may be partial, in this case vision remains relatively sharp.
Diagnostic methods
As diagnostic measures are carried out:
- fundus analysis— the examination is carried out through the pupil; for convenience, it is first dilated with special drops;
- acuity test vision;
- calculation of the boundaries of the field of view ( spheroperimetry);
- grade correct color perception;
Photo 1. You can check color perception using Rabkin’s polychromatic tables. Normally, the eye distinguishes all numbers.
- perimetry using a computer, through which the affected areas of the optic nerve are identified;
- videoophthalmography— determination of the nature of damage to nerve fibers;
- x-ray skulls;
- computed and magnetic resonance imaging;
- dopplerography using a laser - this is optional, additional method diagnostics
Treatment. Is it possible to avoid disability?
During the treatment process, doctors do everything to “revitalize” nerve fibers in maximum quantities.
Important! The earlier the disease was identified and treatment started, the more chances for successful correction of the disease.
Nerves are stimulated by laser, alternating magnetic fields, electric current.
Also used as therapy:
- medicinal impact;
- blood transfusion;
- taking B vitamins and special tonics, promoting vasodilation;
- surgical intervention in severe cases.
Reference. Even if partial optic atrophy is diagnosed, disability must be registered. The purpose of the group depends on the stage of the pathology and the possibility of its correction.
