Causes and treatment of optic nerve atrophy. Optic nerve atrophy (partial and complete) - causes, symptoms, treatment and prevention Optic disc atrophy

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

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

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

How is the disease classified?

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

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

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

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

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

Why can the optic nerve atrophy

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

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

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

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

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

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

What is the clinical picture of the disease

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

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

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

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

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

What are the features of pathology in children

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

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

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

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

How the disease is diagnosed

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

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

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

How is optic nerve atrophy treated?

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

Medication treatment

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

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

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

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

Treatment with folk remedies

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

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

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

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

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

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

leaves of Chinese magnolia vine;
lure roots;
leuzea;
ginseng;
eleutherococcus;
sea buckthorn (fruits and pollen).

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

orange;
cherry;
hawthorn;
cabbage;
corn;
seaweed;
dandelion;
chokeberry;
garlic and onion.

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

What is the prognosis for optic nerve atrophy and its prevention

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

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

Partial optic atrophy is a simpler form of atrophy that affects the fibers responsible for the accuracy of image transmission to the brain. As a rule, the fibers begin to die off, after which they are replaced by connective tissue. And she, in turn, cannot replace the function of the fibers, and therefore there is a decrease in vision and field. There are only 2 forms of atrophy on the optic nerve. It is partial and complete.

By complete is meant the death of the fibers completely, due to which blindness inevitably occurs. Unlike the full form, with a partial one, only a small part of the fibers dies, but this is also fraught with complications. Therefore, it is extremely important to detect atrophy in a timely manner and treat it. 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 information about the image is transmitted to the visual part of the brain. It turns out that when a picture is perceived, a light signal appears, which passes through the retina and enters the brain through the optic nerve. It would seem that everything is simple, but the nerve has an excessively large number of fibers and each of them is responsible for a specific area. If there is a problem of death, then this light signal arrives already in an altered pathological form, as a result of which vision is impaired.

what causes disease

Partial atrophy of the optic nerve causes:

Compression of the optic nerve by various growths or tumors.
retinal pathology.
Glaucoma.
Inflammation in the nerve.
Myopia.
Pathology of the brain.
Infectious manifestations: encephalitis, brain abscess, meningitis, arachnoiditis.
Sclerosis.
Atherosclerosis.
Hypertension.
Heredity.
Chemical poisoning, 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 (initially). There are 4 degrees of severity of the disease. As a rule, the weaker the degree, the less signs are expressed. As the disease progresses, the symptoms worsen and worsen. So, partial atrophy of the optic nerves of both eyes symptoms:

Decreased visual acuity.
When moving the eyes, the patient experiences pain.
Loss of peripheral vision due to narrowing of the field of view. And then it might fall out altogether.
The appearance in the eyes of dark spots, which are characterized as blind.

Treatment of a partial type of nerve atrophy

Unlike the full form, partial atrophy of the optic nerve is still treatable. It is aimed at stopping pathological changes in tissues directly in the optic nerve. In this case, the need is to preserve what is still left in a healthy functional form. Those fibers that have already turned into connective tissue are almost impossible to restore, but even without treatment it is impossible. Otherwise, the pathology will progress, and this will lead to complete blindness.

As a rule, the initial treatment is conservative. Drugs are selected that improve the process of blood supply to the nerve of the visual apparatus, accelerate metabolic processes throughout the body at the cell level, dilate blood vessels, biostimulating drugs and multivitamins. Thanks to such medicines, the visual organ is nourished and saturated with useful substances, swelling of the nerve decreases, the inflammatory process is eliminated, which leads to stimulation of healthy fibers.

In more complex cases, or if drug therapy has not given a positive result, a surgical method of treatment is used. Here, first of all, the cause of the disease is eliminated, in order to avoid further development. In combination with the two listed methods, physiotherapy is recommended. This can be laser correction, electrical stimulation, exposure to the affected organ with 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 disorders of the vascular system, vasoactive drugs and antioxidants are used. It can be "Sermion", "Cavinton" and "Tanakan", as well as "Mexidop", "Mildronate" and "Emoxipin".
If the disease appeared due to disorders of the nervous system, then nootropic and fermentotropic drugs are used. For example, Actovegin, Nootropil, Sopcoseryl, Wobenzym and Fpogenzym.
With toxic partial atrophy, not only vasoactive, nootropic agents are used, but also detoxification and peptide drugs.
With descending atrophy of a partial form, bioregulatory therapy is indicated using drugs such as Cortexin and Epithalamin.
If the disease has arisen against the background of genetic heredity, injury or inflammation, then cytomedines are used ("Cortexin" or "Retinals").

Partial optic atrophy: disability is assumed in the same way as in the case of complete atrophy. But in this case, the 3rd group 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

With partial atrophy of the optic nerve in children, treatment is prescribed almost identical to adults. The same goal is to inhibit the progression and death of fibers. Without fail, they nourish the nerve, saturate it with oxygen. The drugs can be administered both by drip and by injection. Electrophoresis, oxygen therapy and ultrasound procedures are always used.

Atrophy of the optic nerve is usually called the process of partial (PAN), and in some cases - complete destruction of the fibers included in the optic nerve with their replacement by connective tissue.

Causes

According to experts, partial atrophy of the optic nerve is very often caused by: heredity and congenital pathologies, some diseases of the organ of vision, pathologies in the optic nerve itself or in (including inflammation, trauma, swelling, congestion, toxic damage, dystrophy, circulatory disorders and compression of the optic nerve), diseases of the nervous system, general diseases.

Lesions of the central nervous system are considered to be the main "culprits" of the development of atrophy, these include: tumors, syphilitic lesions, meningitis, brain abscesses, encephalitis, skull injuries, disseminated. In addition, the causes of the development of such an anomaly can be atherosclerosis, hypertension, quinine poisoning, profuse bleeding, beriberi.

Starvation of the tissues of the internal structures of the eye due to obstruction of the central or peripheral artery can also cause nerve atrophy. In addition, such atrophy is considered the main symptom.

Manifestations of the disease

In ophthalmology, it is customary to divide optic nerve atrophy into primary and secondary, partial and complete, complete and progressive, as well as unilateral and bilateral.

A characteristic symptom of this pathology is considered to be an intractable decrease in vision. Such a symptom can manifest itself in various ways, depending on the type of atrophy. The progress of the disease leads to a non-stop decrease in vision due to the death of the optic nerve, which ultimately leads to complete blindness. This process proceeds, as a rule, either rapidly - in a few days, or gradually - over the course of months.

Partial atrophy of the optic nerve in its course always has a stop in the process of visual impairment at some stage, after which vision stabilizes. This makes it possible to isolate progressive and complete atrophy.

Visual disturbances during the course of the disease are of the most diverse nature, including changes in visual fields (as a rule, narrowing with loss of "lateral vision"), up to "tunnel vision", when a person sees as if through a tube, i.e. only those objects that are directly in front of it. Such a condition is associated with the appearance of - dark spots in any part of the field of view, any disorder of color perception.

With PAIS, the change in visual fields is not only "tunnel", which is due to the localization of the pathological process. Thus, development in front of the eyes of cattle may indicate a change in the nerve fibers of the central section of the retina or the zone directly close to it. When the nerve fibers of the periphery are affected, a narrowing of the visual fields develops, and when the lesions are deep enough, the disappearance of half of the visual field is observed. These changes may develop in either one or both eyes.

Diagnosis

It is unacceptable to engage in self-diagnosis, and even more so self-treatment with atrophy of the optic nerve, since similar symptoms are also observed in peripheral, in which, at first, lateral vision undergoes a change, with the involvement of the central departments at later stages. It must be remembered that optic nerve atrophy is not always an independent disease. Often, this is a manifestation of a serious disease of the nervous system. Therefore, the establishment of its causes at an early stage is especially important.

The symptoms described above are the reason for the immediate appeal to specialists (including an ophthalmologist and a neurologist).

Diagnosis of optic nerve atrophy is usually not difficult. To identify it, an examination is prescribed, including: determination of visual acuity, its fields, as well as tests for color perception. At the same time, they must be carried out, which can reveal the characteristic pallor of the optic nerve head and some narrowing of the bottom. Measure intraocular pressure.

Often, to clarify the diagnosis, an x-ray examination is prescribed (craniography with a picture of the Turkish saddle), magnetic resonance or computed tomography of the brain, fluorescein angiographic or electrophysiological research methods, using contrast, when the patency of the retinal vessels is inspected.

Laboratory tests are also needed - a complete blood count, its biochemistry, a test for borreliosis, as well as syphilis.

Video about the latest developments in the treatment of PONS

Atrophy of the optic nerve, including partial, is almost impossible to cure, because the affected nerve fibers cannot be restored. There is little hope that there will be an effect from the therapy of those fibers that are not yet completely destroyed and partially retain their vital activity. True, if this moment has already been missed, vision is irrevocably lost.

It is worth remembering that often partial atrophy of the optic nerve is not a separate disease, but develops due to certain pathological processes that develop in the sections of the visual pathway. Therefore, its treatment, as a rule, begins with the elimination of the causes of the pathology. If, by this time, atrophy has not yet developed sufficiently, then within some time (sometimes up to two months), the picture will most likely normalize, with the restoration of visual functions.

Drug treatment for this disease is aimed at the timely elimination of edema and inflammation, improving the trophism of the optic nerve and its blood circulation, and restoring the conductivity of nerve fibers.

It should be noted that this process is lengthy, with a weakly pronounced effect, which is completely absent in advanced cases. Therefore, the success of treatment, of course, depends on how quickly the atrophy is diagnosed.

As noted above, the main thing is the treatment of the disease that caused the atrophy, therefore complex therapy is prescribed with various forms of drugs: eye drops, injections (general and local), tablets, physiotherapy. This treatment aims to:
Improving blood circulation, feeding the nerve vessels. For this, vasodilators are used (complamin, no-shpu, nicotinic acid, papaverine, dibazol, halidor, eufillin, sermion, trental), as well as anticoagulants (heparin or ticlide);
Improving the processes of tissue metabolism and activating the regeneration of affected tissues. For this, biogenic stimulants (aloe extract, peat, etc.), tamines (B1, B2, B6, ascorutin), enzymatic agents (fibrinolysin, lidase), essential amino acids (glutamic acid), as well as immunostimulants (ginseng, eleutorococcus);
Relief of inflammatory processes through hormonal drugs (dexamethasone,);
Improving the functions of the central nervous system (cerebrolysin, nootropil, phezam, emoxipin, cavinton).

Any drugs must be taken strictly according to the scheme prescribed by the attending physician, after the diagnosis is established. Since, only a specialist is able to choose the optimal treatment, taking into account concomitant diseases.

At the same time, physiotherapeutic procedures and acupuncture can be prescribed; sessions of laser, magnetic, as well as electrical stimulation of the tissues of the optic nerve.

Such treatment must be repeated courses several times a year.

With an obvious drop in vision, a disability group can be assigned.

Blinded due to illness and visually impaired, rehabilitation courses are prescribed, which aim to eliminate or compensate for the limitations of life that have arisen due to loss of vision.

Remember that this disease cannot be treated with folk remedies, do not waste precious time on it, when there is still a chance to cure atrophy and preserve vision.

Where to treat?

The choice of a medical institution for the treatment of optic nerve atrophy is a very responsible issue, since the result of treatment, including the prognosis for recovery, depends entirely on the thoroughness of the examination and the professionalism of the doctor. Be sure to pay attention to the degree of equipment of the clinic, as well as the qualifications of its specialists, because only the attention and experience of the medical staff can achieve the best effect in the treatment of eye diseases.

Such a serious ophthalmic disease as descending optic nerve atrophy begins to develop due to degenerative processes..

Sclerotic changes occur in the fibers of the nerve tissues.

In the course of the development of the disease, vision not only deteriorates, but may even disappear. It's connected with death of nerve fibers that carry information about the image of the retina to the brain.

Why does descending optic nerve atrophy occur and how to recognize it?

disease provoke the following reasons:

Effects glaucoma.
Vasoconstriction, squeezing the optic nerve - a tumor occurs in the cranial cavity, as a result, a brain abscess.
Complications myopia.
Development in 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 syphilis, vasculitis, diabetes mellitus or hypertension.
Injuries eyes.
intoxication(ARVI, the use of alcoholic substitutes, narcotic substances, nicotine and quinine).

With the death of the fibers of one optic nerve, the pathology is considered unilateral. atrophy in both eyes cause the following disorders and diseases:

syphilis;
intoxication;
tumor in the cavities of the skull;
circulatory disorder(with atherosclerosis, diabetes mellitus, hypertension).

Symptoms of complete and partial atrophy

Symptoms of the disease depends on the type atrophy. The main symptom of pathology is decreased visual acuity.

Important! With atrophy, improve vision 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:

everything is visible through a tube - tunnel vision;
in front of my eyes regularly spots appear, resembling a mosaic;
image fragment, which is located in the bow, missing, the same is noticed from the side of the temples.

Patients disturbances are observed in color vision. A person does not distinguish between red and does not perceive green shades.

The characteristic symptom of the disease is slow recovery of vision when going out of darkness into light and vice versa. Such a symptom often appears at the beginning of the disease, after which it actively progresses.

Reference. Atrophy may be partial, in which case vision remains relatively sharp.

Diagnostic methods

As diagnostic measures are held:

fundus analysis- the examination is carried out through the pupil, for convenience it is pre-expanded with special drops;
sharpness test vision;
calculation of the boundaries of the field of view ( spheroperimetry);
grade correct perception of colors;

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 detected;
video ophthalmography- determination of the nature of damage to nerve fibers;
x-ray skulls;
computed and magnetic resonance imaging;
dopplerography using a laser is an optional, additional diagnostic method.

Treatment. Can disability be avoided?

In the course of treatment, doctors do everything to "revive" nerve fibers in the maximum amount.

Important! The earlier the disease is diagnosed and treated, the more chances for successful disease management.

Nerves are stimulated with laser, alternating magnetic fields, electric current.

Also used as therapy:

medical impact;
blood transfusion;
taking B vitamins and special tonic drugs, contributing to the expansion of blood vessels;
surgical intervention in severe cases.

Reference. Even if partial atrophy of the optic nerve is diagnosed, need to apply for disability. The purpose of the group depends on the stage of the pathology and the possibility of its correction.

More recently, optic nerve atrophy was considered an incurable disease and inevitably led to blindness. Now the situation has changed. The process of destruction of nerve cells can be stopped and thereby preserve the perception of the visual image.

Atrophy, which is the death of nerve fibers, leads to loss of vision. This is due to the fact that the cells lose the ability to conduct nerve impulses responsible for the transmission of the image. Timely access to a doctor will help stop the development of the disease and avoid blindness.

Classification of optic nerve atrophy

The death of nerve fibers in the visual organs has the following classification:

primary atrophy. It occurs due to disruptions in the nutrition of nerve fibers and circulatory disorders. The disease has an independent nature.
secondary atrophy. A mandatory factor in the existence of a disease is the presence of other diseases. In particular, these are deviations associated with the optic nerve head.
congenital atrophy. The tendency of the organism to the appearance of the disease is observed from birth.
glaucomatous atrophy. Vision remains at a stable level for a long time. The cause of the disease is vascular insufficiency of the cribriform plate as a result of increased intraocular pressure.
partial atrophy. Part of the optic nerve is affected, which ends the spread of the disease. Vision is deteriorating.
complete atrophy. The optic nerve is completely affected. If the development of the disease is not stopped, blindness may occur.
complete atrophy. The deviation has already formed. The spread of the disease stopped at a certain stage.
progressive atrophy. The rapid development of the atrophic process, which can lead to complete blindness.
descending atrophy. Irreversible changes in the optic nerves develop slowly.

An explanation of how partial atrophy differs from complete we see here:

It is important to correctly diagnose the disease in time to avoid consequences leading to blindness. In the early stages, atrophy is treated and vision can be stabilized.

Optic nerve atrophy ICD-10 code

H47.2 Optic nerve atrophy
Paleness of the temporal half of the optic disc

Causes of atrophy

Despite the fact that there are a lot of causes of optic nerve atrophy, in 20% of cases the exact factor that results in the development of the disease cannot be established. The most influential causes of atrophy include:

Pigmentary retinal dystrophy.
Inflammation of nerve tissues.
Defects of blood vessels located in the retina.
Increased intraocular pressure.
Spasmodic manifestations related to the vessels.
Purulent inflammation of the brain tissue.
Inflammation of the spinal cord.
Multiple sclerosis.
Diseases of an infectious type (from simple SARS to more serious diseases).
Malignant or benign tumors.
Various injuries.

Primary descending atrophy can be caused by hypertension, atherosclerosis, or deviations in the development of the spine. The causes of the secondary type of the disease are poisoning, inflammation and injury.

Why does atrophy occur in children

Children are not protected from the appearance of this disease. Optic nerve atrophy occurs in them for such reasons:

Genetic deviation.
Intrauterine and other types of poisoning.
Wrong course of pregnancy.
Hydrocephalus of the brain.
Deviations in the development of the central nervous system.
Diseases affecting the apple of the eye.
Skull deformed from birth.
Inflammatory processes in the brain.
The formation of tumors.

As we can see, the main causes of damage to the nerve cells of the visual organs in children are genetic abnormalities and the wrong way of life of the mother during pregnancy.

One case of infantile atrophy is presented in this commentary:

Symptoms of the disease

Consider the clinical picture for each type of atrophy. The primary form of this disease is characterized by the isolation of the boundaries of the nerves of the disc of the eye, which has acquired an in-depth look. The arteries inside the eye are constricted. With a secondary type of disease, the reverse process is noticeable. Nerve boundaries blur, and blood vessels dilate.

Congenital atrophy is accompanied by an inflammatory process behind the eyeball. In this case, it is impossible to focus vision without the occurrence of unpleasant sensations. The resulting image loses the sharpness of the lines and looks blurry.

A partial form of the disease reaches a certain stage of its development and stops developing. Its symptoms depend on the stage that the disease has reached. This form of atrophy can be indicated by partial loss of vision, flashes of light before the eyes, hallucinatory images, the spread of blind spots, and other abnormalities.

Common signs for all types of optic nerve atrophy are such manifestations:

Limitation of the functionality of the eyes.
External change of the visual disc.
If the capillaries in the macula are damaged, the disease affects central vision, which is reflected in the appearance of seals.
The field of view narrows.
The perception of color spectra changes. First of all, this problem is associated with green shades, and then with red ones.
If the nerve tissues of the periphery are affected, the eyes do not adapt well to changes in distance and illumination.

The main difference between partial and complete atrophy is the degree of reduction in visual acuity. In the first case, vision is preserved, but it deteriorates greatly. Complete atrophy implies the onset of blindness.

hereditary atrophy. Types and symptoms

Hereditary atrophy of the optic nerves has several forms of manifestation:

Infantile. Decreased vision in full occurs from 0 to 3 years. The disease is recessive.
Juvenile blindness. The optic disc turns pale. Vision is reduced to 0.1-0.2. The disease develops in the period from 2 to 7 years. She is dominant.
Opto-oto-diabetic syndrome. Appears in the age range from 2 to 20 years. Concomitant diseases - various types of diabetes, deafness, problems with urination, cataracts, pigmented retinal dystrophy.
Ber's syndrome. Severe disease, which is characterized by a decrease in vision in the first year of life to 0.1-0.05. Concomitant deviations - strabismus, symptoms of neurological disorders and mental retardation, damage to the organs of the pelvic region.
Atrophy depending on gender. In most cases, the disease develops in male children. From early childhood, it begins its manifestation and gradually worsens.
Lester's disease. The age from 13 to 30 years is the period in which the disease occurs in 90% of cases.

Symptoms

Hereditary atrophy develops in stages, despite its acute onset. Over a period of several hours to days, vision rapidly decreases. At first, defects in the optic disc are not noticeable. Then its boundaries lose their clarity, small vessels change in structure. A month later, the disk is cloudier on the side closer to the temple. In most cases, reduced vision remains with the patient for life. Only in 16% of patients it is restored. Irritability, nervousness, headaches, increased fatigue are those signs that indicate the development of hereditary atrophy of the optic nerve.

Diagnosis of optic nerve atrophy

Such studies help to identify the presence of atrophy:

Spheroperimetry - determination of the visual field.
Determination of the degree of visual acuity.
Examination of the fundus with a slit lamp.
Measurement of intraocular pressure.
Computer perimetry - helps to determine the damaged tissue area.
Dopplerography using laser equipment - shows the characteristics of blood vessels.

If a defect in the optic disc is detected, a brain examination is prescribed. An infectious lesion is detected after receiving the results of a blood test. Examinations and collection of data on symptomatic manifestations help to make an accurate diagnosis.

Treatment of optic nerve atrophy

The goal of treatment is to maintain the ability to see at the level that was noted at the time of detection of the disease. It is impossible to improve vision with atrophy of the optic nerves, since tissues that have died as a result of damage are not restored. Most often, ophthalmologists choose such a treatment regimen:

Stimulant drugs.
Drugs that dilate blood vessels. Among them are Papaverine and Noshpa.
tissue therapy. For these purposes, the use of vitamin B and intravenous administration of nicotinic acid are prescribed.
Medicines against atherosclerosis.
Drugs that regulate blood clotting. This may be Heparin or subcutaneous injections of ATP.
ultrasonic impact.
Reflex therapy in the form of acupuncture.
The use of trypsin enzymes.
Intramuscular administration of Pyrogenal.
The procedure of vagosympathetic blockade according to Vishnevsky. It is an injection of a 0.5% solution of Novocain into the area of the carotid artery in order to dilate blood vessels and block sympathetic innervation.

If we talk about the use of physiotherapy techniques, then in addition to acupuncture, such methods of treatment are used:

Color and light stimulation.
Electrical and magnetic stimulation.
Massages to eliminate ischemic manifestations.
Meso- and ozone therapy.
Treatment with leeches (gerudotherapy).
Healing Fitness.
In some cases, blood transfusion is possible.

Here is a possible clinical picture with atrophy and a scheme for its treatment:

A complex of medical and physiotherapeutic measures helps to speed up the healing process. Treatment is aimed at improving metabolism and blood circulation. Spasms and thrombosis that disrupt these processes are eliminated.

Some cases of the disease provide for the possibility of surgical intervention. A medical preparation, the patient's own tissues or donor materials are placed in the retrobulbar space, which contribute to the restoration of damaged areas and the growth of new blood vessels. It is also possible to install an electrical stimulator. It remains in the orbit of the eye for several years. In most cases of treatment of a timely noticed disease, vision can be preserved.

Disease prevention

Measures that will minimize the risk of atrophy are a standard list:

Treat diseases of infectious origin in time.
Eliminate the possibility of injury to the brain and visual organs.
Visit the oncologist regularly to notice oncological diseases in time.
Avoid excessive consumption of alcoholic beverages.
Track your blood pressure.

Periodic examination by an ophthalmologist will help to establish the presence of the disease in time and take measures to combat it. Timely treatment is a chance to avoid complete loss of vision.