Optic nerve atrophy: symptoms and treatment. Partial atrophy of the optic nerve. Treatment of the optic nerve for ocular atrophy - causes Atrophied optic nerve treatment


Atrophy optic nerve characterized by the development of the process of complete or partial death of nerve fibers, accompanied by the replacement of healthy connective tissue.

Types of disease

Optic disc atrophy is divided into several types depending on its etiology. These include:

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

Based on the nature of the course, the following types of this disease are distinguished:

  1. Partial atrophy optic nerve (initial). The main difference between this type is the partial preservation of visual ability, which is most important in case of deteriorated vision (due to which wearing glasses or contact lenses cannot improve the quality of vision). Despite the fact that residual visual ability can usually be preserved, disruptions in color perception often occur. Those areas of the field of view that were saved will continue to be accessible.
  2. Complete atrophy of the optic nerve. In this case, the symptoms of the disease have some similarities with such eye pathologies as cataracts and amblyopia. In addition, this type of disease can manifest itself in a non-progressive form that does not have specific signs. This fact indicates that the state of the necessary visual functions remains stable. However, most often there is a progressive form of pathology, during which rapid loss of vision occurs, which, as a rule, cannot be restored. This greatly complicates the diagnostic process.

Symptoms

If optic atrophy develops, symptoms manifest themselves mainly in the form of deterioration in the quality of vision in both eyes at the same time or in just one.

Restoring visual ability in this case is impossible. Depending on the type of pathology, this symptom may have different manifestations.

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

If partial atrophy of the optic nerve is observed, there is a gradual slowdown in progression, after which it completely stops at a certain stage. At the same time, visual activity stops decreasing. Signs of optic nerve atrophy often appear as: Usually they narrow, which is characterized by loss. lateral vision This symptom

can be practically unnoticeable, but sometimes tunnel vision occurs, that is, when the patient is able to see only those objects that are localized directly in the direction of his gaze, as if through a thin tube. Very often, with atrophy, dark, light or colored spots appear before the eyes, and it becomes difficult for a person to distinguish colors. The appearance of dark or white spots before the eyes (both closed and open) indicates that the destruction process is affecting nerve fibers , which are located in central department

retina or very close to it. Narrowing of the visual fields begins if peripheral nerve tissues have been affected.

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

Causes

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

  • The appearance of atrophy can be triggered by the development of diseases that directly affect the nerve fibers or the retina of the eye.
  • The following pathological processes can be cited as examples:
  • mechanical damage (burn or injury) to the retina;
  • inflammatory processes;
  • congenital optic nerve dystrophy (OND);
  • fluid stagnation and swelling;
  • compression of certain areas of the nerve.

Besides, important role Diseases of the nervous and other body systems play a role in the development of this pathological process.

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

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

More rare causes are alcohol poisoning of the body and intoxication by others. chemicals.

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

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

Diagnostics

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

In most cases, the diagnosis of diseases of this nature does not cause great difficulties. In order to determine an accurate diagnosis, it is necessary first to check the quality visual function, namely, to determine visual acuity and fields and conduct color vision tests. After this, ophthalmoscopy is performed. This procedure makes it possible to identify the pallor of the optic disc and a decrease in the lumens of the fundus vessels, characteristic of such a disease. One more mandatory procedure

is .

  • Very often, diagnosis involves the use of the following instrumental methods:
  • X-ray examination;
  • magnetic resonance imaging (MRI);
  • computed tomography of the brain;
  • electrophysiological diagnostics;

contrast methods (used to determine the patency of retinal vessels). IN mandatory laboratory diagnostic methods are carried out, in particular general and biochemical research

Treatment methods

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

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

In most cases, complex therapy is used, which involves the use medicines and optical surgery. Treatment can be carried out with the following medications:

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

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

Any medicine should be taken only after prescription by the attending physician, observing established dosage. It is strictly prohibited to choose medications on your own.

Quite often, physiotherapeutic procedures are performed during the treatment of optic nerve atrophy. Acupuncture or laser and magnetic stimulation of the optic nerve are especially effective.

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

Surgery is usually prescribed in the presence of neoplasms of various types and hereditary atrophy of the optic nerve. Surgery required if there are congenital anomalies development of the visual organ, for example Leber optic atrophy.

Currently used for Leber optic atrophy and other congenital disorders. following methods surgical intervention:

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

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

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

Prognosis and prevention

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

Lack of timely treatment can provoke very serious complications that lead not only to decreased vision, but also to its complete loss.

In this case, the prognosis is disappointing, since it will no longer be possible to restore visual ability.

arrange regular walks in the fresh air.

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

Video For patients diagnosed with optic nerve atrophy, treatment and prognosis are always highly individual. This disease is practically incurable, but when detected on return the patient to normal life Maybe.

Partial atrophy is reversible if treatment tactics are chosen correctly.

Pledge successful treatment of this pathology – efficiency. The sooner therapy is started, the higher the patient’s chances of recovery.

Another component of success is eliminating the causes. They can become pathologies, causing swelling, inflammation and compression of nerve fibers. Atrophy is also possible after damage blood vessels, feeding the optic nerves. Causes of damage: high blood pressure, atherosclerosis, frequent vascular spasms, toxic damage from alcohol and nicotine products. Injuries and infectious diseases also play a role.

When diagnosed, treatment and prognosis depend on the stage. But in all cases it should be remembered that the restoration of nerve fibers in human body not happening. The impact should be aimed at stopping the pathological process and preserving the remaining healthy tissue.

Drug treatment

In most cases, vasodilators are required: No-Shpa, A nicotinic acid, Papaverine and the like. Their use has a beneficial effect on blood circulation, which slows down when blood vessels narrow and their tissues degrade.

Those patients who have blood thickening are prescribed Heparin and Tiklid. These are anticoagulant drugs that normalize blood consistency and eliminate the risk of blood clots.

To enhance metabolism in nerve tissues it is used biogenic stimulants. The preparations Peat and Aloe Extract are indicated. Heparin ointment is applied locally.

It is mandatory to support the body with B vitamins and ascorbic acid. Vitamins can be taken orally in the form of tablets; injections are prescribed for accelerated vitaminization.

To improve immunity, natural preparations based on eleutherococcus and ginseng are used. They enhance regeneration, suppress inflammation and improve general state. Immunostimulants are especially necessary for infectious causes atrophy.

If there are no contraindications to taking hormones, Prednisolone or Dexamethasone is prescribed. This allows you to quickly relieve inflammation. To expose the work of the central nervous system and oxygen saturation of tissues, Cavinton, Phezam, Emoxipin should be taken.

All of these drugs can only be used under the supervision of a physician. Treatment can be carried out either at home with regular follow-up consultations with an ophthalmologist, or in a hospital. The regimen depends on the stage of the pathology and the complexity of its cause.

Physiotherapy for optic nerve atrophy

The list of physiotherapeutic effects includes several methods:

  • Acupuncture;
  • Electrophoresis;
  • Ultrasound therapy;
  • Laser stimulation:
  • Magnetotherapy

These procedures enhance the effect of the medications taken. However good effect They give only in case of incomplete loss of nerve cells.

Surgical treatment of optic nerve atrophy

If there is a threat of blindness that cannot be treated with drugs and physiotherapy, it is prescribed surgical intervention. One of four operations is prescribed;

  • Vasoreconstructive;
  • Extrascleral;
  • Decompression;
  • Choroidal revascularization.

During vasoreconstructive surgery, the doctor ligates the vessels of the temporal or parietal artery. As a result, blood flow is redistributed and blood supply to the ophthalmic artery is improved.

During extrascleral intervention, the surgeon artificially creates a focus of inflammation in the area surrounding the optic nerve. This occurs by transplanting the patient's own tissue. The result of the intervention is improved blood circulation and nerve nutrition.

The essence of decompression surgery is the dissection of the scleral or bone canal of the optic nerve. After tissue healing, outflow venous blood intensifies, the level of pressure inside the nerve decreases, and its performance increases.

Choroidal revascularization is the most complex operation. During the intervention, bundles of the rectus ocular muscle are transplanted. This causes the formation and development of new blood vessels. The result is increased nutrition of the optic nerve and the cessation of the loss of its cells.

Treatment of optic nerve atrophy with folk remedies

Home remedies cannot have a serious effect on the condition of the optic nerve during atrophy. However, you should not refuse them - they can be beneficial as an addition to drug therapy prescribed by your doctor.

Some popular recipes:

  • Dissolve 0.2 g in 1 glass of warm water and drink before lunch. Repeat the same before dinner. Take the mummy solution in this mode for 3 weeks.
  • Infuse 2 tablespoons of dried astragalus herb per 300 ml. water for 4 hours. Drink 100 ml. 3 times a day for 2 months.
  • Squeeze the juice from the peppermint herb and mix with water and honey in a 1:1:1 ratio. Apply this mixture to your eyes in the mornings and evenings. At the same time, it is useful to consume fresh peppermint with food, and also make tea from it.
  • Prepare an infusion from a teaspoon of a mixture of dill, cornflower, pharmaceutical chamomile, parsley and black tea on a glass hot water. Do lotions after working at the computer.
  • Grind 1 kg. pine cones and add water so that it completely covers the crushed raw materials. Cook for 30 minutes over low heat. Cool, strain, mix with 1 glass of honey and leave in the refrigerator. Take 1 time per day - in the morning strictly on an empty stomach.
  • Infuse 1 tbsp. l. leaves dried parsley for 200 ml. boiling water for 24 hours. Take 1 tbsp once a day in the morning. l.

Prognosis after treatment

In patients who come to the clinic in the initial stages of the disease, positive dynamics are observed in almost all cases. Vision is preserved and sometimes even improved. Despite this, it is impossible to achieve complete restoration of vision with optic nerve atrophy.

It is worth remembering that when diagnosed with initial atrophy of the optic nerve, treatment and prognosis depend not only on the ophthalmologist, but also on the patient. Only compliance with all doctor’s recommendations provides a full guarantee of improvements. Violation of the treatment plan, regimen, or recommended diet may result in a lack of effect from therapy. Treatment in the later stages of the disease is practically useless. Due to the large loss of nerve cells, the likelihood of blindness is high even after taking all possible measures.

A rapid decrease in vision may indicate various eye diseases. But rarely does anyone think that it can be caused by such dangerous disease as optic nerve atrophy. The optic nerve is an important component in the perception of light information. Therefore, it is worth taking a closer look at this disease so that it is possible to identify the symptoms in the early stages.

What it is?

The optic nerve is a nerve fiber responsible for processing and transmitting light information. The main function of the optic nerve is to deliver nerve impulses to the brain area.

The optic nerve is attached to retinal ganglion neurocytes, which make up the optic disc. Light rays, converted into a nerve impulse, are transmitted along the optic nerve from the retinal cells to the chiasma (the segment where the optic nerves of both eyes intersect).

Where is the optic nerve located?

Its integrity ensures high. However, even the smallest injuries to the optic nerve can lead to severe consequences. The most common disease of the optic nerve is its atrophy.

Optic atrophy is an eye disease in which the optic nerve deteriorates, resulting in decreased vision. With this disease, the fibers of the optic nerve completely or partially die and are replaced connective tissue. As a result, light rays falling on the retina of the eye are converted into an electrical signal with distortions, which narrows the field of view and reduces its quality.

Depending on the degree of damage, optic nerve atrophy can be partial or complete. Partial optic nerve atrophy differs from complete atrophy in less pronounced manifestation diseases and maintaining vision at a certain level.

Vision correction traditional methods ( , contact lenses) are absolutely ineffective for this disease, since they are aimed at correcting the refraction of the eye and have nothing to do with the optic nerve.

Causes

Optic nerve atrophy is not an independent disease, but is a consequence of some pathological process in the patient’s body.

Optic atrophy

The main causes of the disease include:

  • Eye diseases (retinal diseases, eyeball, eye structures).
  • Pathologies of the central nervous system (brain damage due to syphilis, brain abscess, skull injury, brain tumors, multiple sclerosis, encephalitis, meningitis, arachnoiditis).
  • Diseases of cardio-vascular system(cerebral atherosclerosis, arterial hypertension, vasospasm).
  • Long-term toxic effects of alcohol, nicotine and narcotic drugs. Alcohol poisoning with methyl alcohol.
  • Hereditary factor.

Optic nerve atrophy can be congenital or acquired.

Congenital optic atrophy occurs as a result of genetic diseases(in most cases of Leber's disease). In this case, the patient has low quality of vision from birth.

Acquired optic atrophy appears as a result of certain diseases in older age.

Symptoms

The main symptoms of partial visual atrophy may be:

  • Deterioration in the quality of vision and the inability to correct it with traditional correction methods.
  • Pain when moving the eyeballs.
  • Change in color perception.
  • Narrowing of visual fields (up to the appearance tunnel syndrome, in which the ability to peripherally view is completely lost).
  • The appearance of blind spots in the field of vision (scotomas).

Methods laser correction view can be seen in .

Stages of optic nerve atrophy

Diagnostics

Typically, diagnosing this disease does not cause any particular difficulties. As a rule, the patient notices a significant decrease in vision and consults an ophthalmologist, who makes the correct diagnosis. Identifying the cause of the disease is of great importance.

To identify optic nerve atrophy in a patient, a complex diagnostic methods:

  • (visual acuity test).
  • Spheroperimetry (determination of visual fields).
  • Ophthalmoscopy (detection of pallor of the optic nerve head and narrowing of the fundus vessels).
  • Tonometry (measurement of intraocular pressure).
  • Video-ophthalmography (study of the optic nerve relief).
  • (examination of areas of the affected nerve).
  • Computed tomography and magnetic resonance imaging (a study of the brain to detect possible reasons, causing optic nerve atrophy).

Read what computer perimetry determines in ophthalmology.

Except ophthalmological examination the patient may be prescribed an examination by a neurologist or neurosurgeon. This is necessary because the symptoms of optic nerve atrophy may be symptoms of an incipient intracranial pathological process.

Treatment

Treatment of optic nerve atrophy is quite complex. Destroyed nerve fibers cannot be restored, so first of all it is necessary to stop the process of changes in the tissues of the optic nerve. Since the nerve tissue of the optic nerve cannot be restored, visual acuity cannot be raised to the previous level. However, the disease must be treated to avoid its progression and blindness. The prognosis of the disease depends on the timing of the start of treatment, so it is advisable to immediately consult an ophthalmologist when the first symptoms of the disease are detected.

The difference between partial optic nerve atrophy and complete one is that this form of the disease is treatable and it is still possible to restore vision. The main goal in the treatment of partial optic nerve atrophy is to stop the destruction of optic nerve tissue.

The main efforts should be aimed at eliminating. Treatment of the underlying disease will stop the destruction of optic nerve tissue and restore visual function.

During the treatment of the underlying disease that caused optic nerve atrophy, complex therapy. Additionally, during treatment, medications can be used to improve blood supply and nutrition to the optic nerve, improve metabolism, eliminate swelling and inflammation. It would be a good idea to take multivitamins and biostimulants.

The main drugs used are:

  • Vasodilators. These drugs improve blood circulation and trophism in the tissues of the optic nerve. Among the drugs in this group one can highlight complamin, papaverine, dibazol, no-shpu, halidor, aminophylline, trental, sermion.
  • Drugs that stimulate the restoration of altered tissues of the optic nerve and improve metabolic processes in him. These include biogenic stimulants (peat, aloe extract), amino acids (glutamic acid), vitamins and immunostimulants (eleuthorococcus, ginseng).
  • Drugs that resolve pathological processes and metabolic stimulants (phosphaden, pyrogenal, preductal).

It is necessary to understand that drug therapy does not treat optic nerve atrophy, but only helps to improve the condition of the nerve fibers. To cure optic nerve atrophy, it is necessary to first cure the underlying disease.

Physiotherapeutic procedures, which are used in combination with other treatment methods, are also important. Also, methods of magnetic, laser and electrical stimulation of the optic nerve are effective. They help improve functional state optic nerve and visual functions.

As additional treatment The following procedures apply:

  • Magnetic stimulation. During this procedure, the optic nerve is exposed to a special device that creates an alternating magnetic field. Magnetic stimulation helps improve blood supply, saturate the tissues of the optic nerve with oxygen, and activate metabolic processes.
  • Electrical stimulation. This procedure is carried out using a special electrode, which is inserted behind the eyeball to the optic nerve and electrical impulses are applied to it.
  • Laser stimulation. The essence of this method is non-invasive stimulation of the optic nerve through the cornea or pupil using a special emitter.
  • Ultrasound therapy. This method effectively stimulates blood circulation and metabolic processes in the tissues of the optic nerve, improves the permeability of the blood-ophthalmic barrier and the sorption properties of eye tissues. If the cause of optic nerve atrophy is encephalitis or tuberculous meningitis, then the disease will be quite difficult to treat with ultrasound.
  • Electrophoresis. This procedure is characterized by the effect of low-power direct current and drugs on the eye tissue. Electrophoresis helps to dilate blood vessels, improve cell metabolism and normalize metabolism.
  • Oxygen therapy. This method consists of saturating the tissues of the optic nerve with oxygen, which helps improve metabolic processes in them.

During treatment of optic nerve atrophy, it is imperative to maintain a high-quality, saturated diet various vitamins And minerals. It is necessary to consume fresh vegetables and fruits, cereals, meat, and dairy products more often.

See what foods improve vision.

It is not recommended to treat the disease with folk remedies, since in this case they are ineffective. If you only hope for folk remedies, you can lose precious time when the quality of vision could still be preserved.

Complications

It must be remembered that optic nerve atrophy is serious illness and you should not treat it yourself. Incorrect self-treatment can lead to dire consequences - complications of the disease.

The most serious complication may be complete loss of vision. Ignoring treatment leads to further development disease and a steady decrease in visual acuity, as a result of which the patient will no longer be able to lead his previous lifestyle. Very often, with optic nerve atrophy, the patient becomes disabled.

Also read about heterochromia.

Prevention

To avoid the occurrence of optic nerve atrophy, it is necessary to treat diseases in a timely manner, consult an ophthalmologist in a timely manner if visual acuity decreases, and not expose the body to alcohol and drug intoxication. Only if you pay due attention to your health can you reduce the risk of disease.

Video

(optic neuropathy) - partial or complete destruction of the nerve fibers that transmit visual stimuli from the retina to the brain. Optic nerve atrophy leads to decreased or complete loss of vision, narrowing of visual fields, impaired color vision, and pallor of the optic disc. The diagnosis of optic atrophy is made when identifying characteristic features diseases using ophthalmoscopy, perimetry, color testing, determination of visual acuity, craniography, CT and MRI of the brain, B-scanning ultrasound of the eye, angiography of retinal vessels, study of visual EP, etc. For optic nerve atrophy, treatment is aimed at eliminating the pathology that led to this complication.

ICD-10

H47.2

General information

Various diseases of the optic nerve in ophthalmology occur in 1-1.5% of cases; of these, 19 to 26% lead to complete atrophy of the optic nerve and incurable blindness. Pathomorphological changes in optic nerve atrophy are characterized by destruction of axons of retinal ganglion cells with their glial-connective tissue transformation, obliteration capillary network optic nerve and its thinning. Optic nerve atrophy may result from large quantity diseases occurring with inflammation, compression, swelling, damage to nerve fibers or damage to the blood vessels of the eye.

Causes of optic nerve atrophy

Factors leading to optic nerve atrophy may include eye diseases, central nervous system lesions, mechanical damage, intoxication, general, infectious, autoimmune diseases and etc.

The causes of damage and subsequent atrophy of the optic nerve are often various ophthalmopathologies: glaucoma, pigmentary degeneration of the retina, occlusion of the central retinal artery, myopia, uveitis, retinitis, optic neuritis, etc. The danger of damage to the optic nerve may be associated with tumors and diseases of the orbit: meningioma and optic nerve glioma, neuroma, neurofibroma, primary orbital cancer, osteosarcoma, local orbital vasculitis, sarcoidosis, etc.

Among diseases of the central nervous system, the leading role is played by tumors of the pituitary gland and posterior cranial fossa, compression of the area of ​​the optic chiasm (chiasm), purulent-inflammatory diseases (brain abscess, encephalitis, meningitis), multiple sclerosis, traumatic brain injuries and damage to the facial skeleton accompanied by injury optic nerve.

Often optic nerve atrophy is preceded by hypertension, atherosclerosis, starvation, vitamin deficiency, intoxication (poisoning with alcohol substitutes, nicotine, chlorophos, medicinal substances), large simultaneous blood loss (usually with uterine and gastrointestinal bleeding), diabetes mellitus, anemia. Degenerative processes in the optic nerve can develop with antiphospholipid syndrome, systemic lupus erythematosus, Wegener's granulomatosis, Behcet's disease, Horton's disease.

Congenital atrophies of the optic nerve occur with acrocephaly (tower-shaped skull), micro- and macrocephaly, craniofacial dysostosis (Crouzon's disease), hereditary syndromes. In 20% of cases, the etiology of optic nerve atrophy remains unclear.

Classification

Optic nerve atrophy can be hereditary or non-hereditary (acquired). Hereditary forms of optic atrophy include autosomal dominant, autosomal recessive and mitochondrial. The autosomal dominant form can have a severe or mild course, and is sometimes combined with congenital deafness. An autosomal recessive form of optic nerve atrophy occurs in patients with Wehr, Wolfram, Bourneville, Jensen, Rosenberg-Chattorian, and Kenny-Coffey syndromes. The mitochondrial form is observed when there is a mutation in mitochondrial DNA and accompanies Leber's disease.

Acquired optic nerve atrophy, depending on etiological factors, can be primary, secondary and glaucomatous in nature. The mechanism of development of primary atrophy is associated with compression of peripheral neurons visual pathway; The optic disc is not changed, its boundaries remain clear. In the pathogenesis of secondary atrophy, swelling of the optic disc occurs due to pathological process in the retina or the optic nerve itself. The replacement of nerve fibers by neuroglia is more pronounced; The optic disc increases in diameter and loses its clear boundaries. The development of glaucomatous optic atrophy is caused by the collapse of the lamina cribrosa of the sclera against the background of increased intraocular pressure.

Based on the degree of color change of the optic nerve head, initial, partial (incomplete) and complete atrophy are distinguished. The initial degree of atrophy is characterized by slight blanching of the optic disc while maintaining the normal color of the optic nerve. With partial atrophy, disc blanching in one of the segments is noted. Complete atrophy is manifested by uniform pallor and thinning of the entire optic nerve head, and narrowing of the fundus vessels.

Based on localization, ascending (if retinal cells are damaged) and descending (if optic nerve fibers are damaged) atrophy is distinguished; by localization - one-sided and two-sided; according to the degree of progression - stationary and progressive (determined during dynamic observation by an ophthalmologist).

Symptoms of optic atrophy

The main sign of optic nerve atrophy is a decrease in visual acuity that cannot be corrected with glasses and lenses. With progressive atrophy, a decrease in visual function develops over a period of several days to several months and can result in complete blindness. In case of incomplete optic nerve atrophy pathological changes reach a certain point and do not develop further, and therefore vision is partially lost.

With optic nerve atrophy, disturbances in visual function can manifest themselves as concentric narrowing of the visual fields (disappearance of lateral vision), the development of “tunnel” vision, color vision disorder (mainly green-red, less often - blue-yellow part of the spectrum), the appearance dark spots(scotoma) in areas of the visual field. Typically, an afferent pupillary defect is detected on the affected side - a decrease in the pupil's reaction to light while maintaining a friendly pupillary reaction. Such changes can occur in one or both eyes.

Objective signs of optic nerve atrophy are revealed during an ophthalmological examination.

Diagnostics

When examining patients with optic nerve atrophy, it is necessary to find out the presence of concomitant diseases, the fact of taking medications and contact with chemicals, the presence of bad habits, as well as complaints indicating possible intracranial lesions.

During a physical examination, the ophthalmologist determines the absence or presence of exophthalmos, examines the mobility of the eyeballs, checks the reaction of the pupils to light, and the corneal reflex. Visual acuity testing, perimetry, and color vision testing are required.

Basic information about the presence and degree of optic nerve atrophy is obtained using ophthalmoscopy. Depending on the reasons and form optical neuropathy The ophthalmoscopic picture will vary, but there are typical characteristics encountered with various types optic nerve atrophy. These include: pallor of the optic disc varying degrees and prevalence, changes in its contours and color (from grayish to waxy), excavation of the disc surface, a decrease in the number of small vessels on the disc (Kestenbaum’s symptom), narrowing of the caliber of the retinal arteries, changes in the veins, etc. The condition of the optic disc is clarified using tomography (optical coherence , laser scanning).

To prevent optic nerve atrophy it is necessary timely treatment ophthalmic, neurological, rheumatological, endocrine, infectious diseases; prevention of intoxication, timely blood transfusion in case of profuse bleeding. At the first signs of visual impairment, consultation with an ophthalmologist is necessary.

Restoration of the optic nerve after glaucoma.

Until now traditional medicine I have not found a solution to restore optic nerve dystrophy. This applies to advanced situations. When medicine is already powerless. Blindness after glaucoma is the most common consequence of the disease. It is necessary to combat such a disease in advance in order to prevent irreversible actions.

As a result, vision is impaired.

The optic nerve is directly connected to the human brain. A huge number of neurons flow from the retina back to the brain every second, a constant circulation that instantly reflects the color contrast and picture for us. With proper, natural blood supply, no problems arise. However, who has encountered glaucoma and found it on late stage, are faced with optic nerve dystrophy. This disease is the necrosis of the main source of vision, the nerve canal. With constant high eye pressure, the natural processes, the capillaries narrow so much that a sufficient number of neurons do not reach their final destination. With a prolonged absence of nerve input to the retina, dystrophy begins, leading to the death of healthy channels responsible for vision. The entire nerve trunk is subject to shock and stress. Irreversible consequences begin. At the same time, the cells of the eyeball die and the optic nerve is affected, which leads to inevitable blindness.

How to restore the optic nerve.

Since it is a nerve, its recovery is extremely difficult. If nerve cells preserved some percentage of vital activity, it will be possible to restore vision. Applicable drug treatment. Swelling and inflammation are eliminated and blood supply is restored. Physiotherapy, acupuncture, surgery also have positive dynamics. Completely destroyed nerve fibers cannot be restored. Modern medicine It is only at the stage of developing the latest technologies and has not officially found solutions to the treatment of blindness. A lot of research is being done and laboratory experiments, but so far only on animals.

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