Partial atrophy of the optic nerve. Toxic lesions of the optic nerve Indications for hospitalization

When vision rapidly begins to deteriorate, many run to a specialist. In some cases, the cause of such changes is atrophy optic nerve. This disease can have a rapid course and very quickly leave a person blind, without the right to recovery.

Optic nerve atrophy is a condition in which the nutrition of nerve cells is disrupted. This leads to them stopping performing their functions. If the process continues for a long time, the neurons gradually die. Over time, the disease affects everything larger number cells, with severe course- the entire nerve trunk. It will be almost impossible to restore normal tissue functioning. To understand how this pathology progresses and develops, one should imagine the course of impulses to brain structures. They are mentally divided into two parts:

lateral;
medial.

The literal part contains an “image” of surrounding objects that are visualized inner part eyes (near the bridge of the nose). Medial part perceives images from the outer part (near the temple) of the organ of vision. Both parts of the picture are formed by back wall eyeball, after which they are sent to different structures of the brain. This path is complex, but there is one fundamental point - almost immediately after the signal leaves the orbit, the internal parts are crossed.

This causes the left tract to receive visualizations from the left side of the organ of vision, and the right tract to receive pictures from the right parts. Therefore, damage to one of the nerves will cause dysfunction in both eyes.

Classification of optic nerve atrophy

Total or partial atrophy of the optic nerve can be either hereditary or non-acquired. Hereditary forms of optic atrophy (treatment is not always possible):

Autosomal dominant. This form is often accompanied by hearing loss and has both mild and severe forms.
Autosomal recessive. The considered form of the pathological process occurs in people with pathologies such as Wehr, Wolfram, Bourneville, Jensen, Rosenberg-Chattorian, Kenny-Coffey syndrome.
Mitochondrial. This form of pathology in children (treatment does not produce results) and in adults is diagnosed by mutation of mitochondrial DNA and is not an independent disease. It always accompanies Leber's disease.

Acquired pathologies, depending on the provoking factors, have the following character:

Primary. This type anomalies develop due to compression of peripheral neurons of the visual pathway. The optic disc (OND) has no visible changes and has clear boundaries.
Secondary. With this type of pathology, swelling of the optic nerves is observed caused by pathological processes in the tissues. The optic disc loses its clear boundaries, becomes more elongated and increases in size. The degeneration of nerve tissue becomes more pronounced.
Glaucomatous. The development of glaucomatous pathology is caused by the collapse of the lamina cribrosa of the sclera against the background of increased intraocular pressure.

Based on the type of optic disc and its color, nerve atrophy can be:

initial;
partial (incomplete);
complete atrophy.

For initial stage The anomaly is characterized by slight blanching of the optic disc while maintaining the normal color of the optic nerve tissue. Partial atrophy of the optic nerve - pallor of one segment. Complete atrophy of the optic nerve is characterized by total pallor and thinning of the entire optic disc plane, as well as narrowing of the vessels of the organ of vision.

According to localization, there is ascending and descending atrophy of the optic nerve. The pathology can also be unilateral or bilateral. According to the speed of development - stationary and progressive.

Why does optic nerve atrophy occur?

The causes of optic nerve atrophy may be as follows:

heredity;
congenital pathology;
ophthalmological pathologies;
pathological processes in the retina and optic nerve;
abnormal conditions nervous system;
general diseases.

In most cases, optic nerve atrophy in children and adults occurs due to abnormalities of the central nervous system and poisoning of various types.

Also, the reasons for the development of anomalies may be:

hypertension;
atherosclerosis;
quinine intoxication;
lack of vitamins;
lack of food and nutrients;
profuse blood loss.

Optic disc atrophy ( main feature glaucoma) occurs as a consequence of impaired arterial patency retina, delivering nutrition to the optic nerve.

Symptoms of optic nerve atrophy

The main symptoms of complete and partial atrophy the optic nerve can be:

Impaired quality of visual perception. Correct vision traditional way does not seem possible.
Pain syndrome when moving the eyes.
Change in color perception.
Reduced fields of view. There may be a disease called carpal tunnel syndrome, in which it is possible to see only what is located in front of the person, there is no peripheral vision.
Formation of blind spots (scotomas).

If you notice any of these symptoms, you should immediately contact your eye doctor.

Establishing diagnosis

The diagnosis, optic atrophy, is rarely determined. The main thing is for a person to consult a doctor in a timely manner; it is necessary to determine how to treat this disease. Disability due to ocular nerve atrophy is what most people with this diagnosis expect.

To confirm the diagnosis, the person is referred to an ophthalmologist for a fundus examination. This technique allows you to visualize the initial part of the nerve trunk of the visual organs.

How is an eye examination performed? In the standard version, the fundus is visualized by a specialist in a dark room, using a specialized mirror device and a flashlight.

The use of modern devices (electronic ophthalmoscope) makes it possible to carry out this study faster and obtain more accurate data. There is no need for special preparation to carry out the procedure. It is not possible using this procedure to recognize the most early form anomalies, since symptoms of the pathological process occur long before a visual change in the fibers occurs.

General tests are of no value in making a diagnosis. In modern clinics, to identify the provoking factor of the disease and pathological changes in the structure of the nerve, methods such as:

Fluorescein angiography (FA). The patient is injected with a coloring component through a vein, from where it enters the vessels of the organ of vision. Using a specialized device that emits light rays of different frequencies, the fundus of the eye is illuminated and its condition is examined. Through this type of diagnosis, it is possible to identify signs of insufficient blood flow and damage to nerve structures.
Laser tomography of the optic disc (HRTIII). A method that allows you to study the structure of the eye without surgery. Determines pathological changes in the initial part of the nerve of the optic organ.
Optical coherence tomography of the optic disc. Using high-precision infrared radiation determine the condition of nerve tissue.
CT and MRI. Methods that allow you to examine various areas without surgery human body. This technique allows you to examine any structure with an accuracy of 1 centimeter. The use of such diagnostics allows you to quickly determine the root cause of the anomaly. Typically, this method is used to determine the presence of neoplasms of various etiologies.

Treatment is carried out immediately after the patient’s treatment. The slightest delay can cost a person his sight. With further examination, therapy is adjusted. If you wait for the results of the examination without starting treatment, changes in the tissues of the organs of vision may occur that cannot be reversed.

Treatment of optic atrophy

Can optic nerve atrophy be cured? Where can the disease be cured? Is stem cell treatment possible? These questions interest many. Therapy of the pathology in question is a difficult task, even for the most competent specialist. You should know that a damaged nerve cannot be restored by any means. But you can hope for a certain effect from the treatment.

It is possible to avoid losing vision only if therapy is started at the stage of tissue destruction, and not when the process is completed. Living nerve fibers can be restored and saved. If this moment is missed, the patient will remain blind for life.

As a rule, the pathology in question is only a concomitant illness and there is another disease of the visual organs. This suggests that it is important to combine treatment of optic nerve atrophy with eliminating the underlying cause that caused the abnormal changes. In case of timely elimination of the root cause and if the pathology has not yet affected a large number of cells, within 14-60 days the condition of the fundus of the eye is restored and the optic nerves and its functions are regenerated.

Therapy is aimed at:

to eliminate swelling and inflammation in the optic nerve;
to improve blood flow and metabolism in eye tissues;
to restore the conductivity of nerve tissue.

It is worth noting that the therapy for the pathology in question is long-term, and the result from it is weakly expressed, and sometimes completely absent, as a rule, in advanced forms. Therefore, it is important to start therapy at the beginning of the development of the pathological process.

The main aspect of recovery, in the absence of additional pathologies, is the treatment of the underlying disease, namely, destruction of the optic nerve. In this regard, they carry out complex therapy exactly that pathology. For this purpose the use is shown various forms pharmacological agents:

drops for the organs of vision;
injections (general and local);
medicines in tablet form;
physiotherapy.

Directed therapy:

To improve blood flow in the vascular fibers supplying nutrition to the nerve. Apply vasodilators, anticoagulants.
To improve metabolism in nerve tissues and activate the regeneration of altered tissues. Are used biogenic stimulants, vitamins, medications containing amino acid enzymes, immunomodulators.
To eliminate abnormal changes and activate metabolism within cells.
Hormonal medications are used to eliminate inflammation.
To improve the functioning of the central nervous system.

Pharmacological agents should be taken only in the dosage specified by the ophthalmologist. Without the help of a specialist, it is not possible to choose the right treatment. If there are no additional somatic diseases, you are allowed to take medications such as:

"No-shpa";
"Papaverine";
amino acids;
vitamin complexes;
"Emoxipin";
"Nootropil";
"Fezam."

Note! It is prohibited to undergo treatment without consulting a specialist.

Also used for the treatment of anomalies:

physiotherapy;
acupuncture;
magnetic stimulation of eye nerve tissue;
laser stimulation of nerve tissue;
electrical stimulation of the nerve of the organ of vision.

Important! Therapy must be repeated after some time.

Nutrition for the disease in question should be correct and varied. You should eat fresh fruits and vegetables, meat and seafood.

Important! If during the course of the disease a person loses significant vision, the question of disability may be raised.

Persons with severely impaired vision are shown a course of rehabilitation, the main direction of which is the elimination or compensation of restrictions Everyday life that arose after the development of pathology.

Therapy with folk remedies leads to a loss of time, which is necessary for real treatment. Folk remedies for such severe pathology are not effective.

(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 can be a consequence of a large number of diseases that occur 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, 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 atrophy of the optic nerve, depending on the etiological factors, can be primary, secondary and glaucomatous in nature. The mechanism of development of primary atrophy is associated with compression of peripheral neurons of the visual pathway; The optic disc is not changed, its boundaries remain clear. In the pathogenesis of secondary atrophy, swelling of the optic disc occurs, caused by a 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 the case of incomplete atrophy of the optic nerve, 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 of dark spots (scotoma) on the areas of the field of view. 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 in the process ophthalmological examination.

Diagnostics

When examining patients with optic atrophy, it is necessary to determine the presence concomitant diseases, the fact of taking medications and contact with chemicals, Availability 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 appearance will vary, but there are typical characteristics found in different types of optic 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 eye, 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.

Optic nerve atrophy is a disease characterized by the gradual death of optic nerve fibers.

As a result, information from the retina of the eye passes in a distorted form to the brain.

This process is often the result of various ophthalmological diseases.

Optic nerve atrophy most often affects people in adulthood, and some types develop only in men through hereditary transmission.

To prevent a person from losing his vision, it is necessary to diagnose the disease in time and begin its treatment. And for therapy to be as effective as possible, it is important to determine what type of optic nerve atrophy the patient has developed.

Description of the disease

The optic nerve is a channel through which the image transmitted to the retina as electronic impulses is transmitted directly to the brain. Already there all the signals turn into a regular picture.

This optic nerve feeds a large number of vessels. If, due to any disease, its nutrition is disrupted, then the fibers of this optic nerve are also destroyed over time.

As a result, the nerve tissue is replaced connective tissue or glia (auxiliary cells of nervous tissue that normally protect neurons). The nerve dies over time and can no longer transmit signals to the brain from the retina as before.

Kinds

Optic nerve atrophy can be primary or secondary.

Primary atrophy, as a rule, develops as an independent disease. It is transmitted in a recessive manner by inheritance. This disease is linked exclusively to the X chromosome, which is why only men suffer from this pathology. It manifests itself at 15-25 years of age.
Secondary atrophy usually develops after the course of any disease, with the development of stagnation of the optic nerve or a violation of its blood supply. This disease develops in any person and at absolutely any age.

Causes of atrophy

The causes of atrophy are:

various infectious diseases(syphilis, meningitis, herpes, encephalitis, influenza);
circulatory disorders (vasculitis, embolism or thrombosis of blood vessels of the eye);
poisoning;
traumatic brain or eye injuries;
degenerative diseases that affect the nervous system;
increased intracranial or intraocular pressure;
compression of the optic nerve (cysts, oncological diseases, abscesses, malunion after a skull fracture).

Symptoms

Correct diagnosis is the key successful treatment. Symptoms different types atrophies may vary. The following forms are distinguished:

Primary

With the help of ophthalmoscopy, a pale optic disc with clearly visible boundaries is detected. The formation is flat in appearance, shaped like a saucer.

Vision deteriorates, the reaction of the pupil to light changes, it can twitch convulsively, not concentrating in one place.

Color vision is distorted; most often, like colorblind people, red and green tones are confused, less often blue and yellow shades. Areas of the visual field fall out and disappear from view lower sections or side views.

On top visible objects black spots may appear - scotomas, and on late stages tunnel vision develops, that is, a person sees everything as if through a microscope or a narrow tube. The arterial vessels in the retina of the eye are often narrowed.

Secondary

With it, as with the primary one, paleness of the optic nerve head is characteristic, but its boundaries are unclear and blurred. In the early stages, dilation of the blood vessels in the eye is observed, but later they may narrow again.

It is easier to identify secondary atrophy at the first stage of the disease, while the symptoms are pronounced; over time they become less acute, but the disease remains, which makes treatment difficult. The patient begins to see worse, the viewing angle becomes much narrower, and sometimes individual sectors disappear from the field of view.

Compression atrophy

This process most often develops due to a tumor or cyst in the orbit or inside cranium. The symptoms are similar to ordinary atrophy - blurred vision, narrowing of the visual field, complete or partial - depending on the affected area.

If the optic nerve is directly compressed, then the pathology develops only on one side, when the entire optic tract atrophy is bilateral.

Hereditary atrophy

Also known as Leber's disease. Only men in the world suffer from this type of optic atrophy. at a young age in several generations, but it is transmitted only through the female line. First, the sharpness decreases, the sharpness decreases, and the field of view narrows. This occurs over several months, and subsequently complete or partial primary atrophy of the optic nerve develops with blanching of its disc.

Atrophy after severe bleeding

In this case, vision deteriorates and the lower field may fall out. The blanching of the optic disc has no distinct boundaries, as is the case with secondary atrophy. It does not develop immediately after bleeding, but after some time.

For tabes and paralysis

In this case, the disease progresses slowly and visual impairment develops over a long period of time. The symptoms can be compared to simple primary atrophy: this is a deterioration in vision, a change in the visual field - it narrows significantly, and in many cases there is a partial narrowing of the visual field.

In addition, the disease impairs color perception, and in most cases it causes atherosclerosis of the retina.

Atrophy in atherosclerosis of the carotid artery

Hypertensive patients suffer from atrophy, which in its manifestations is most similar to secondary atrophy; the field of vision with it can change in different ways, namely, simply decrease, blur, or partially disappear. Scotomas in this case appear extremely rarely.

Although different kinds atrophies differ significantly in the reasons for their development and clinical picture, the main and most important manifestations of this disease, which occur in all its varieties Two symptoms remain:

significant decrease in visual acuity;
loss of areas of the visual field.

Diagnostics

Unlike other diseases, with optic nerve atrophy it is completely unacceptable to engage in self-medication or self-diagnosis.

Quite similar symptoms are inherent in a disease such as peripheral cataract, when initial stage only violated peripheral vision, and after that gradually the central departments.

It is important to remember that optic atrophy is not always independent disease or a consequence of some local eye pathology.

In some cases, it is a symptom of a serious nervous system disease. Therefore, it is very important to establish its causes as early as possible.

If one of the symptoms is detected, you should immediately contact a professional specialist (neurologist or ophthalmologist).

Sometimes, to clarify the diagnosis, it becomes necessary to conduct some examinations:

x-ray examination,
magnetic resonance or computed tomography brain,
electrophysiological or fluorescein angiographic studies, as a result of which, using intravenously administered contrast (a special substance), it is possible to check the patency of all retinal vessels.

Laboratory tests (syphilis test, general analysis blood, borreliosis).

An examination by an ophthalmologist should include:

visual acuity test;
examination through the pupil (diluted with special drops) of the entire fundus of the eye;
spheroperimetry (precise determination of the boundaries of the field of view);
laser dopplerography;
assessment of color perception;
craniography with an image of the sella turcica;
computer perimetry (allows you to identify which part of the nerve is damaged);
video-ophthalmography (allows us to identify the nature of damage to the optic nerve);
computed tomography, as well as magnetic nuclear resonance (clarifies the cause of optic nerve disease).

Treatment

At the first suspicion of atrophy, a targeted examination by an ophthalmologist is required. In addition, a consultation with a neurologist or neurosurgeon may also be required.

Until now, no methods have been published that would allow one to quickly and permanently get rid of of this disease. The doctor’s main task is to “revive” as many nerve fibers as possible.

It is for this purpose that direct stimulation of the entire optic nerve is used - various alternating magnetic fields, laser and electric current. The earlier an accurate diagnosis is made, the better the results of the treatment will be.

Magnetic stimulation is a special effect of an alternating magnetic field that can activate everything metabolic processes and accelerate healing directly to the optic nerve. And in cases where the disease has not yet advanced, 10-15 sessions are enough to noticeably improve vision.

All these methods are combined with the most traditional therapy:

tonic and vasodilator drugs,
all B vitamins,
blood replacement fluid
blood transfusion.

You can also resort to surgery. Its main goal is to establish the delivery of drugs to the nervous tissue.

Treatment with folk remedies

To treat such a serious illness they use medicinal herbs that it offers ethnoscience, but they can help only to a certain extent and at the initial stage of the disease.

It is not advisable to self-medicate, but use various decoctions and infusions corresponding to folk recipes as additional medicines possible only after consultation with an ophthalmologist.

Wild mallow tincture for the treatment of optic nerve atrophy

Most an effective recipe To treat such a serious illness, use a tincture of wild mallow or wild mallow. Dry crushed roots of these plants in the amount of 3 tablespoons must be mixed with the same amount of burdock, and then boiled for about half an hour in 1.5 liters of water.

Already in the finished decoction you need to add primrose (2 parts), lemon balm (3 parts) and dolnik herb (4 parts). Let the broth cool and strain. Ready product You need to take 1 tablespoon three times a day for a month.

Treatment of night blindness with blue cornflower

People believe that blue cornflower helps cure night blindness. In order to prepare such an infusion, you need 1 teaspoon of dried or fresh flowers, pour boiling water (250 ml) and leave to stand for 1 hour.

Take the prepared infusion three times a day, half an hour before meals, 0.50 ml. In case of blepharitis, it is recommended to wash the eyes with this infusion twice a day.

Decoction of lemon, pine cones and rue herb

Full course of treatment folk recipe is around 25-30 days. This decoction is prepared from rue grass (25 g), cut when it is in flower, unripe pine cones (100 pieces), as well as one small lemon, divided into 4 pieces.

This mixture must be filled with water (2.5 liters), and then added 0.5 cups of sugar and boiled for half an hour. You need to take the drug 1 tablespoon before meals three times a day.

Prevention

The following preventive measures can be distinguished:

Warnings for all types of intoxication.
Consultation with a specialist if the patient has the slightest doubt about visual acuity.
Timely treatment of diseases affecting the development of optic nerve atrophy.
Blood transfusions in case of profuse bleeding.

Optic nerve atrophy - quite serious illness. In case of even the slightest decrease in vision, it is necessary to visit an ophthalmologist so as not to miss precious time to treat the disease. There is no treatment, and the atrophy will be progressive, vision may disappear altogether, and in this case it will not be possible to restore it.

It is very important to identify the reason why optic nerve atrophy develops and eliminate it in a timely manner. Complete absence treatment most often leads not only to loss of vision, but also to death. In addition, when treating with folk remedies, there is too little effectiveness, and in rare cases, danger.

Forecast

Absolutely any disease, with timely treatment, becomes less terrible and responds much better to therapy. Also with atrophy: when treating the disease on early stage It is possible to restore the nerve, as well as avoid frightening consequences and preserve your vision.

If the disease is neglected, it will most likely lead to blindness, which is why at the first symptoms of changes in color perception, decreased visual acuity, or narrowing of visual fields, you should contact an ophthalmologist. The doctor will help you preserve your vision with your help.

Symptoms

In ophthalmology, it is customary to distinguish primary and secondary atrophy of the optic nerve, complete and progressive, partial and complete, as well as unilateral and bilateral forms of the disease.

The main symptom of this pathology is uncorrectable visual impairment. This symptom can manifest itself in different ways, depending on the type of atrophy. Progressive atrophy leads to a steady decrease in vision due to the death of the optic nerve, which can lead to complete vision loss. This process, as a rule, occurs either rapidly - within a few days, or occurs gradually, over several months.

With partial atrophy, the process of vision deterioration stops at some stage, and vision stabilizes. Thus, it is possible to distinguish between progressive and complete atrophy.

Visual impairment with atrophy can be very diverse; including a change in visual fields (usually narrowing, when “lateral vision” disappears), up to the development of “tunnel vision”, in which a person sees as if through a tube, namely, sees only objects that are directly in front of him. This condition is accompanied by the appearance of dark spots in any part of the visual field or a color perception disorder.

Depending on the localization of the pathological process, changes in visual fields are not only tunnel-like. Thus, the development of cattle ( dark spots) before the eyes indicates damage to the nerve fibers in the central part of the retina or in its immediate vicinity. A narrowing of the visual field also develops in cases where peripheral nerve fibers are affected, and if the lesions are deep enough, we are talking about the disappearance of half the visual field. Such changes can occur in one or both eyes.

If you discover signs of optic nerve atrophy, you should immediately seek help from a specialist in order to prevent irreversible consequences of the disease.

Diagnostics

According to the ICD, optic nerve atrophy has ICD code 10. It is unacceptable to engage in self-diagnosis or self-medication for this pathology, because similar symptoms are also inherent in peripheral vision, when lateral vision is first impaired, and only then the central parts are involved. It is worth remembering that atrophy is not always an independent disease or a consequence of some local eye pathology; sometimes it is a symptom of a serious, severe disease of the nervous system. That is why it is very important to establish its causes as early as possible.

If the symptoms described above occur, you should immediately contact a specialist (ophthalmologist, neurologist).

Diagnosing optic atrophy is usually not difficult. Its basis is the determination of visual acuity and fields (), as well as the study of color perception. In addition, the ophthalmologist will definitely perform an ophthalmoscopy, which will reveal pallor of the optic disc and narrowing of blood vessels in the fundus, and measure intraocular pressure.

Sometimes, to clarify the diagnosis, it becomes necessary to conduct an X-ray examination (craniography with a mandatory image in the area of the sella turcica), computer or magnetic resonance imaging of the brain, electrophysiological or fluorescein angiographic research methods, in which using a special substance (contrast) administered intravenously , you can check the patency of the retinal vessels.

Laboratory tests also provide the necessary information, including a general blood test and its biochemistry, a test for syphilis, and borelliosis.

Early diagnosis of the disease will help get rid of it with minimal consequences. So, with optic nerve atrophy in children, treatment of young patients may not be so serious, but will cost only vitamins, vasoconstrictors and biostimulating drugs, and its results can often be positive.

Treatment

Depending on the severity of the disease, we can talk about partial or complete atrophy of the optic nerve. At partial damage tissues may still have the possibility of their rehabilitation, but a more serious stage can lead to serious consequences.

Optic nerve atrophy is practically untreatable, because destroyed nerve fibers simply cannot be restored. There is little hope for the effect of therapy for fibers that are in the process of destruction, but have so far retained their vital functions. However, if this moment is missed, the vision of the affected eye will be lost forever.

It must be borne in mind that optic nerve atrophy is often not an independent disease, but develops as a consequence of certain pathological processes parts of the visual pathway. That is why, as a rule, its treatment begins with eliminating the causes of the pathology. If atrophy has not yet developed by this time, then within some time (from two weeks to two months) the picture may normalize and visual functions will be restored.

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

It should be noted that this process is lengthy, with a weakly expressed effect, which in advanced cases is completely absent. Therefore, for the success of the enterprise, treatment must be started very quickly.

As noted above, the main thing here is the treatment of the disease - the cause of atrophy, against which complex therapy is prescribed using various forms of drugs: eye drops, injections (general and local), tablets, physiotherapy. Such treatment is usually directed towards:

1. To improve blood circulation in the vessels supplying the nerve, using vasodilators (nicotinic acid, complamin, no-shpu, papaverine, dibazol, aminophylline, halidor, sermion, trental) and anticoagulants (ticlid, heparin);

2. To improve metabolic processes in nerve tissues and stimulate the regeneration of altered tissue, using biogenic stimulants (peat, aloe extract, etc.), vitamins (B1, B2, B6), enzymes (fibrinolysin, lidase), amino acids (glutamic acid ), immunostimulants (eleuthorococcus, ginseng);

4. For cupping inflammatory processes with help hormonal drugs(prednisolone, );

5. To improve the functioning of the central nervous system (, Cerebrolysin, nootropil, Fezam, Cavinton).

Medicines are taken only as prescribed by a doctor and after an accurate diagnosis has been established. Only a specialist can choose the optimal treatment, taking into account concomitant diseases.

At the same time, physiotherapeutic treatment and acupuncture are used; There are methods of magnetic, laser, and electrical stimulation of the optic nerve.

In some cases, with optic nerve atrophy, surgery and surgical intervention may also be relevant. According to research results, optic fibers are not always dead, some may be in a parabiotic state and can be returned to life with the help of a professional with extensive experience.

Treatment is repeated in courses several months later.

If there is an obvious decrease in vision, the question of assigning a disability group to the patient may be raised.

Blind and visually impaired persons should be prescribed a course of rehabilitation that, if possible, eliminates or compensates for the limitations in life activity that arise as a result of vision loss.

It is worth knowing that for this disease, treatment with folk remedies is absolutely ineffective, in addition, it threatens to waste precious time when it is still possible to cure atrophy, and therefore restore vision.

Therefore, having learned your diagnosis, you should not panic and supplement the prescribed treatment with improvisation. Instead of specifying which folk remedies from optic nerve atrophy exist, focus on finding a competent and responsible specialist who will help solve your problem.

The question “where to cure optic nerve atrophy” was asked by absolutely every patient who suffered from this disease. Don't trust unverified people medical centers, fall for marketing tricks and focus on advertising.

Choosing a clinic for the treatment of optic nerve atrophy is a very important question, because the result of treatment and prognosis largely depend on the completeness of the examination and the professionalism of the attending physician. Pay attention to the level of equipment of the clinic and the qualifications of the specialists working in it, because it is the attention and experience of the clinic’s doctors that allows you to achieve the best results in the treatment of eye diseases.

Make sure that the attending physician not only makes a specific diagnosis, but can also indicate the causes of optic atrophy, which may affect the nuances of the prescribed treatment

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

TO descending atrophy lead to 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 extensive education in the cavity of the orbit or in the cavity of the skull, degenerative process, myopia, etc.).

Each etiological factor causes atrophy of the optic nerve with certain typical ophthalmoscopic features, for example, glaucoma, circulatory disorders in the vessels supplying the optic nerve. However, there are characteristics common to optic atrophy of any nature: blanching of the optic disc and impairment visual functions.

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.

Based on the ophthalmoscopic picture, primary (simple) atrophy is distinguished, which is characterized by pallor of the optic nerve head with clear boundaries. The number of small vessels on the disc is reduced (Kestenbaum's symptom). The retinal arteries are narrowed, the veins may be of normal caliber or also slightly narrowed.

Depending on the degree of damage to the optic fibers, and therefore 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.

The time during which pallor of the optic nerve head develops and its severity depend not only on the nature of the disease that led to optic nerve atrophy, but also on the distance of the source of damage from the eyeball. So, for example, with inflammatory or traumatic injury optic nerve, the first ophthalmoscopic signs of optic nerve atrophy appear several days to several weeks after the onset of the disease or the moment of injury. At the same time, when a space-occupying lesion affects the optic fibers in the cranial cavity, at first only visual disorders are clinically manifested, and changes in the fundus in the form of optic nerve atrophy develop after many weeks and even months.

Congenital optic 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.

When identifying ophthalmoscopic signs of optic nerve atrophy, it is necessary to conduct a thorough clinical examination of the patient, including determination of visual acuity and the boundaries of the visual field for white, red and green colors, study of intraocular pressure.

If atrophy develops against the background of papilledema, even after the edema disappears, the boundaries and pattern of the disc remain unclear. This ophthalmoscopic picture is called secondary (post-edema) optic nerve atrophy. The retinal arteries are narrowed in caliber, while the veins are dilated and tortuous.

When clinical signs of optic nerve atrophy are detected, it is necessary first of all to establish the cause of the development of this process and the level of damage to the optic fibers. For this purpose, not only a clinical examination is carried out, but also CT and/or MRI of the brain and orbits.

In addition to etiologically determined treatment, symptomatic complex therapy is used, including vasodilator therapy, vitamins C and B, drugs that improve tissue metabolism, various options stimulating therapy, including electrical, magnetic and laser stimulation of the optic nerve.

Hereditary atrophies come in six forms:

with a recessive type of inheritance (infantile) - from birth to three years of age there is a complete decrease in vision;
with the dominant type (juvenile blindness) - from 2-3 to 6-7 years. The course is more benign. Vision decreases to 0.1-0.2. In the fundus there is segmental blanching of the optic disc; there may be nystagmus and neurological symptoms;
opto-oto-diabetic syndrome - from 2 to 20 years. Atrophy is combined with retinal pigmentary dystrophy, cataracts, sugar and diabetes insipidus, deafness, defeat urinary tract;
Beer's syndrome is a complicated atrophy. Bilateral simple atrophy already in the first year of life, reggae drops to 0.1-0.05, nystagmus, strabismus, neurological symptoms, damage to the pelvic organs, the pyramidal tract suffers, joins mental retardation;
gender-related (more often observed in boys, develops in early childhood and grows slowly);
Leicester's disease (Lester's hereditary atrophy) - in 90% of cases occurs between the ages of 13 and 30 years.

Symptoms Acute onset sharp drop vision for several hours, less often - several days. The lesion is a type of retrobulbar neuritis. The optic disc is initially unchanged, then blurring of the boundaries and changes in small vessels appear - microangiopathy. After 3-4 weeks, the optic disc becomes paler on the temporal side. In 16% of patients, vision improves. Most often, reduced vision remains for life. Patients are always irritable, nervous, and worried headache, fatigue. The cause is optochiasmatic arachnoiditis.

Optic nerve atrophy in some diseases

Optic nerve atrophy is one of the main signs of glaucoma. Glaucomatous atrophy is manifested by paleness of the disc and the formation of a depression - an excavation, which first occupies the central and temporal sections, and then covers the entire disc. Unlike the above diseases leading to disc atrophy, with glaucomatous atrophy the disc has grey colour, which is associated with the characteristics of the damage to its glial tissue.
Syphilitic atrophy.

Symptoms The optic disc is pale, gray, the vessels are of normal caliber and sharply narrowed. Peripheral vision narrows concentrically, there is no scotoma, color perception suffers early. There may be progressive blindness that occurs quickly, within a year.

It occurs in waves: a rapid decrease in vision, then during the period of remission - improvement, during the period of exacerbation - repeated deterioration. Miosis develops, divergent strabismus, changes in pupils, lack of reaction to light while maintaining convergence and accommodation. The prognosis is poor, with blindness occurring within the first three years.

Features of optic nerve atrophy from compression (tumor, abscess, cyst, aneurysm, sclerotic vessels), which can be in the orbit, anterior and posterior cranial fossa. Peripheral vision suffers depending on the location of the process.
Foster-Kennedy syndrome - atherosclerotic atrophy. Compression can cause carotid artery sclerosis and sclerosis ophthalmic artery; Ischemic necrosis occurs from softening during arterial sclerosis. Objectively - excavation caused by retraction of the cribriform plate; benign diffuse atrophy (with sclerosis of small vessels of soft meninges) grows slowly, accompanied by atherosclerotic changes in the retinal vessels.

Optic nerve atrophy with hypertension is the outcome of neuroretinopathy and diseases of the optic nerve, chiasm and optic tract.