Optic nerve atrophy: symptoms and treatment. Partial atrophy of the optic nerve. Partial atrophy of the optic nerve

Update: December 2018

The quality of life is primarily affected by the state of our health. Free breathing, clear hearing, freedom of movement - all this is very important for a person. Violation of the work of even one organ can lead to a change in the usual way of life in a negative direction. For example, a forced refusal from active physical activity (jogging in the morning, going to the gym), eating delicious (and fatty) foods, intimate relationships, etc. This is most clearly manifested in the defeat of the organ of vision.

Most eye diseases proceed quite favorably for a person, since modern medicine is able to cure them or reduce the negative effect to nothing (correct vision, improve color perception). Complete and even partial atrophy of the optic nerve does not belong to this "majority". With this pathology, as a rule, the functions of the eye are significantly and irreversibly impaired. Often patients lose the ability to perform even daily activities and become disabled.

Can this be prevented? Yes, you can. But only with the timely detection of the cause of the disease and adequate treatment.

What is optic nerve atrophy

This is a condition in which the nervous tissue experiences an acute lack of nutrients, due to which it ceases to perform its functions. If the process continues long enough, neurons begin to gradually die off. Over time, it affects an increasing number of cells, and in severe cases, the entire nerve trunk. It will be almost impossible to restore the function of the eye in such patients.

To understand how this disease manifests itself, it is necessary to imagine the course of impulses to brain structures. They are conditionally divided into two portions - lateral and medial. The first one contains a “picture” of the surrounding world, which is seen by the inner side of the eye (closer to the nose). The second is responsible for the perception of the outer part of the image (closer to the crown).

Both parts are formed on the back wall of the eye, from a group of special (ganglion) cells, after which they are sent to various brain structures. This path is quite difficult, but there is only one fundamental point - almost immediately after leaving the orbit, a crossover occurs with internal portions. What does this lead to?

• The left tract perceives the image of the world from the left half of the eyes;
• The right one carries the "picture" from the right halves to the brain.

Therefore, damage to one of the nerves after it has left the orbit will result in a change in the function of both eyes.

The reasons

In the vast majority of cases, this pathology does not occur on its own, but is a consequence of another eye disease. It is very important to take into account the cause of optic nerve atrophy, or rather the place of its occurrence. It is from this factor that the nature of the symptoms in the patient and the characteristics of therapy will depend.

There may be two options:

1. Ascending type - the disease occurs from that part of the nerve trunk that is closer to the eye (before the crossover);
2. Descending form - the nervous tissue begins to atrophy from top to bottom (above the decussation, but before entering the brain).

The most common causes of these conditions are presented in the table below.

Treatment of optic nerve atrophy is closely related to identifying the cause. Therefore, close attention should be paid to its clarification. The symptoms of the disease can help in the diagnosis, which make it possible to distinguish the ascending form from the descending one.

Symptoms

Regardless of the level of the lesion (above or below the chiasm), there are two reliable signs of optic nerve atrophy - a loss of visual fields ("anopsia") and a decrease in visual acuity (amblyopia). How they will be expressed in a particular patient depends on the severity of the course of the process and the activity of the cause that caused the disease. Let's take a closer look at these symptoms.

Loss of visual fields (anopsia)

What does the term "field of view" mean? In fact, this is just a zone that a person sees. To imagine it, you can close half of the eye on either side. In this case, you see only half of the picture, since the analyzer cannot perceive the second part. We can say that you have “dropped out” one (right or left) zone. This is what anopsia is - the disappearance of the field of vision.

Neurologists divide it into:

• temporal (half of the image, located closer to the temple) and nasal (the other half from the side of the nose);
• right and left, depending on which side the zone falls on.

With partial atrophy of the optic nerve, there may be no symptoms, as the remaining neurons transmit information from the eye to the brain. However, if a lesion occurs through the entire thickness of the trunk, this sign will definitely appear in the patient.

What areas will fall out of the patient's perception? It depends on the level at which the pathological process is located and on the degree of cell damage. There are several options:

This neurological symptom seems difficult to perceive, but thanks to it, an experienced specialist can identify the site of the lesion without any additional methods. Therefore, it is very important that the patient speaks openly to his doctor about any signs of visual field loss.

Decreased visual acuity (amblyopia)

This is the second sign that is observed in all patients without exception. Only the degree of its severity varies:

1. Light - characteristic of the initial manifestations of the process. The patient does not feel a decrease in vision, the symptom manifests itself only when carefully examining distant objects;
2. Medium - occurs when a significant part of neurons is damaged. Distant objects are practically invisible, at a short distance the patient does not experience difficulties;
3. Severe - indicates the activity of the pathology. The sharpness is reduced so much that even nearby objects become difficult to distinguish;
4. Blindness (synonymous with amorrhosis) is a sign of complete atrophy of the optic nerve.

As a rule, amblyopia occurs suddenly and gradually increases, without adequate treatment. If the pathological process proceeds aggressively or the patient did not seek help in a timely manner, there is a possibility of developing irreversible blindness.

Diagnostics

As a rule, problems with the detection of this pathology are rare. The main thing is that the patient seeks medical help in a timely manner. To confirm the diagnosis, he is sent to an ophthalmologist for an examination of the fundus. This is a special technique with which you can examine the initial section of the nerve trunk.

How is ophthalmoscopy performed?. In the classic version, the doctor examines the fundus in a dark room, using a special mirror device (ophthalmoscope) and a light source. The use of modern equipment (electronic ophthalmoscope) allows you to conduct this study with greater accuracy. The patient does not require any preparation for the procedure and special actions during the examination.

Unfortunately, ophthalmoscopy does not always detect changes, since the symptoms of the lesion occur earlier than tissue changes. Laboratory studies (blood, urine, cerebrospinal fluid tests) are non-specific and have only auxiliary diagnostic value.

How to act in this case? In modern multidisciplinary hospitals, to detect the cause of the disease and changes in the nervous tissue, there are the following methods:

Therapy of the disease begins from the moment the patient contacts, since it is irrational to wait for the results of the diagnosis. During this time, the pathology may continue to progress, and changes in the tissues will become irreversible. After clarifying the cause, the doctor adjusts his tactics in order to achieve the optimal effect.

Treatment

It is widely believed in society that "nerve cells do not regenerate." This is not entirely correct. Neurocytes can grow, increase the number of connections with other tissues and take on the functions of dead "comrades". However, they do not have one property that is very important for complete regeneration - the ability to reproduce.

Can optic nerve atrophy be cured? Definitely not. With partial damage to the trunk, medications can improve visual acuity and visual fields. In rare cases, even virtually restore the patient's ability to see to normal levels. If the pathological process has completely disrupted the transmission of impulses from the eye to the brain, only surgery can help.

For successful treatment of this disease, it is necessary, first of all, to eliminate the cause of its occurrence. This will prevent/reduce cell damage and stabilize the pathology. Since there are a large number of factors that cause atrophy, the tactics of doctors can differ significantly in various conditions. If it is not possible to cure the cause (malignant tumor, hard-to-reach abscess, etc.), you should immediately start restoring the working capacity of the eye.

Modern methods of nerve restoration

Even 10-15 years ago, the main role in the treatment of optic nerve atrophy was assigned to vitamins and angioprotectors. Currently, they only have an additional meaning. Drugs that restore the metabolism in neurons (antihypoxants) and increase blood flow to them (nootropics, antiaggregants, and others) come to the fore.

The modern scheme for restoring the functions of the eye includes:

• Antioxidant and antihypoxant (Mexidol, Trimetazidine, Trimectal and others) - this group is aimed at restoring tissues, reducing the activity of damaging processes, and eliminating the "oxygen starvation" of the nerve. In a hospital, they are administered intravenously; in outpatient treatment, antioxidants are taken in the form of tablets;
• Microcirculation correctors (Actovegin, Trental) - improve metabolic processes in nerve cells and increase their blood supply. These drugs are one of the most important components of treatment. Available also in the form of solutions for intravenous infusions and tablets;
• Nootropics (Piracetam, Cerebrolysin, Glutamic acid) - stimulators of neurocyte blood flow. Accelerate their recovery;
• Drugs that reduce vascular permeability (Emoxipin) - protects the optic nerve from further damage. It was introduced into the treatment of eye diseases not so long ago and is used only in large ophthalmological centers. It is injected parabulbarno (a thin needle is passed along the wall of the orbit into the surrounding tissue of the eye);
• Vitamins C, PP, B 6 , B 12 are an additional component of therapy. These substances are believed to improve metabolism in neurons.

The above is a classic treatment for atrophy, but in 2010 ophthalmologists proposed fundamentally new methods for restoring the work of the eye, using peptide bioregulators. At the moment, only two drugs are widely used in specialized centers - Cortexin and Retinalamin. In the course of studies, it has been proven that they improve the condition of vision by almost two times.

Their effect is realized through two mechanisms - these bioregulators stimulate the restoration of neurocytes and limit damaging processes. The method of their application is quite specific:

• Cortexin - is used as an injection into the skin of the temples or intramuscularly. The first method is preferred, since it creates a higher concentration of the substance;
• Retinalamin - the drug is injected into the parabulbar tissue.

The combination of classical and peptide therapy is quite effective for nerve regeneration, but even it does not always achieve the desired result. Additionally, recovery processes can be stimulated with the help of directed physiotherapy.

Physiotherapy for optic nerve atrophy

There are two physiotherapy methods, whose positive effect is confirmed by scientific research:

• Pulsed magnetotherapy (PMT) - this method is not aimed at restoring cells, but at improving their work. Due to the directed action of magnetic fields, the contents of neurons “thicken”, which is why the generation and transmission of impulses to the brain is faster;
• Bioresonance therapy (BT) - its mechanism of action is associated with the improvement of metabolic processes in damaged tissues and the normalization of blood flow through microscopic vessels (capillaries).

They are very specific and are used only in large regional or private ophthalmological centers, due to the need for expensive equipment. As a rule, for most patients, these technologies are paid, so BMI and BT are used quite rarely.

Surgical treatment of atrophy

In ophthalmology, there are special operations that improve visual function in patients with atrophy. They can be divided into two main types:

1. Redistributing blood flow in the eye area - in order to increase the flow of nutrients to one place, it is necessary to reduce it in other tissues. For this purpose, part of the vessels on the face is tied up, which is why most of the blood is forced to go through the ophthalmic artery. This type of intervention is performed quite rarely, as it can lead to complications in the postoperative period;
2. Transplantation of revascularizing tissues - the principle of this operation is to transplant tissues with abundant blood supply (parts of the muscle, conjunctiva) into an atrophic area. New vessels will grow through the graft, which will ensure adequate blood flow to the neurons. Such an intervention is much more widespread, since other tissues of the body practically do not suffer from it.

A few years ago, methods of stem cell treatment were actively developed in the Russian Federation. However, an amendment to the country's legislation made these studies and the use of their results in humans illegal. Therefore, at present, technologies of this level can only be found abroad (Israel, Germany).

Forecast

The degree of vision loss in a patient depends on two factors - the severity of the damage to the nerve trunk and the time of initiation of treatment. If the pathological process has affected only part of the neurocytes, in some cases, it is possible to almost completely restore the functions of the eye, against the background of adequate therapy.

Unfortunately, with atrophy of all nerve cells and the cessation of impulse transmission, the patient is likely to develop blindness. The way out in this case may be surgical restoration of tissue nutrition, but such treatment is not a guarantee of restoration of vision.

FAQ

Question:
Could this disease be congenital?

Yes, but very rarely. In this case, all the symptoms of the disease described above appear. As a rule, the first signs are found at the age of up to a year (6-8 months). It is important to contact an ophthalmologist in a timely manner, since the greatest effect of the treatment is observed in children under 5 years of age.

Question:
Where can optic nerve atrophy be treated?

It should be emphasized once again that it is impossible to completely get rid of this pathology. With the help of therapy, it is possible to control the disease and partially restore visual functions, but it cannot be cured.

Question:
How often does the pathology develop in children?

No, these are quite rare cases. If a child has a diagnosed and confirmed diagnosis, it is necessary to clarify whether it is congenital.

Question:
What is the most effective treatment with folk remedies?

Atrophy is difficult to treat even with highly active drugs and specialized physiotherapy. Folk methods will not have a significant impact on this process.

Question:
Do disability groups give for atrophy?

It depends on the degree of vision loss. Blindness is an indication for the appointment of the first group, acuity from 0.3 to 0.1 - for the second.

All therapy is taken by the patient for life. In order to control this disease, short-term treatment is not enough.

Optic nerve atrophy is the destruction of the nerve fibers that perceive visual stimuli through the retina and send them to the brain. The destruction of fibers can be not only complete, but also partial. With this pathology, vision is reduced or lost completely. The observed fields may narrow, color perception may be disturbed, the optic disk of the optic disc may turn pale.

The ophthalmologist makes such a diagnosis after examination with an ophthalmoscope, color perception testing, perimeter testing, craniography, visual acuity testing, CT, brain, eye scanning with ultrasound, etc.

Treatment of the disease will be aimed at eliminating the cause that led to such serious consequences. Restoration of the optic nerve is a complex process that requires a competent approach. With some types of pathology, this is not possible. Especially dangerous is atrophy of the optic nerves of both eyes.

What is atrophy

Diseases of the optic nerve are diagnosed by ophthalmologists less often (1-1.5%). Only a fifth of them eventually lead to complete blindness.

The essence of the problem is that during the destruction of the optic nerve, the axons of the cells that form the retina are destroyed. The cells themselves are deformed, and the nerve becomes thinner, its capillaries are destroyed. More often than not, adults suffer from this disease. In infants, it is caused by infectious diseases, hydrocephalus, hereditary syndromes, and autoimmune diseases.

The process itself can develop in different ways, it can be quite fast or relatively slow. Often there is a blockage of blood vessels, which has an extremely negative effect on the condition of the nerve tissues. A person loses visual acuity, and this happens quite abruptly. If it is possible to achieve an improvement in the blood supply to the nerve tissues, they cease to be destroyed and even partially restored.

Please note that such negative factors can lead to atrophy: severe alcohol poisoning, damage to the body by viral infections, eye diseases, hereditary predisposition, severe profuse bleeding, hypertension, atherosclerosis, tumors.

Atrophy is the result of many diseases in which swelling, inflammation, compression, damage to blood vessels or nerve fibers of the eyes appear. You can restore vision if you immediately start treatment, until the atrophy itself has completely affected the nerve.

Let's understand the reasons

The causes of optic nerve atrophy are quite diverse. The most common are tumors, neurological pathologies, infections, diseases of large and small vessels.

All factors are divided into several groups:

1. diseases of the eyes themselves;
2. dysfunction of the central nervous system;
3. intoxication;
4. injury;
5. general diseases, etc.

Often, atrophy can be caused by ophthalmic causes:

1. glaucoma;
2. occlusion of the artery that feeds the retina;
3. death of retinal tissue;
4. uveitis;
5. myopia;
6. neuritis, etc.

A tumor or disease of the orbit can damage the nerve.

If we talk about diseases of the central nervous system, then pituitary tumors, inflammatory diseases (meningitis, encephalitis, arachnoiditis, abscess), multiple sclerosis, (head injuries), and injury to the optic nerve when the face is damaged are in the lead.

Even prolonged hypertension, beriberi, starvation, intoxication can cause atrophy. Among the latter, poisoning with technical alcohol, chlorophos, nicotine, etc. is very dangerous. Sudden blood loss, anemia, diabetes can also adversely affect the condition of the optic nerve fibers.

Serious damage to the body by infection can lead to atrophy. Dangerous and toxocariasis and toxoplasmosis.

Atrophy is also congenital, and in an infant it may not be detected immediately. This reduces his chances of restoring visual function. Often this disease appears in premature babies, it can also be inherited from parents. A newborn cannot say that he sees poorly or that something hurts him, therefore parents should carefully monitor the behavior of the crumbs. At the first suspicion, you should consult a doctor.

Acrocephaly, macrocephaly, microcephaly, dysostosis, hereditary syndromes lead to the congenital form. In a fifth of cases of visual atrophy, its causes cannot be determined at all.

Classification

Optic nerve atrophy can be both acquired and hereditary. In the latter case, deafness often joins. It can be relatively light or heavy.

Acquired ailment can be primary, secondary, glaucomatous. In primary atrophy, the peripheral neurons of the optic nerve are compressed. The boundaries of the ONH remain clear.

With atrophy of the secondary optic disc, edematous, a pathological process occurs in the retina or nerve. Nerve fibers are eventually replaced by neuroglia, which causes the diameter of the optic disc to grow, and its boundaries become blurred.

With glaucomatous optic atrophy, due to high intraocular pressure, collapse and death of the cribriform plate of the sclera occurs.

The ophthalmologist can determine, as the color of the optic disc changes, at what stage the pathological process is (initial stage, partial, complete atrophy). At the initial stage, the optic disc becomes slightly pale, the nerve itself retains the correct color. If the atrophy is partial, only part of the nerve (segment) turns pale. At full - the entire disk turns pale and thinner, the vessels of the fundus narrow, can be damaged.

According to the location, atrophy is distinguished:

• ascending and descending;
• unilateral and bilateral.

As it progresses, it happens:

• stationary;
• progressive.

Symptoms

Symptoms may vary in their manifestation. It all depends on the root cause of the disease. The main symptom is reduced vision, and this process cannot be corrected either with lenses or with glasses. How quickly vision is lost depends on the type of atrophy, its cause. If it is a progressive type, then vision may decrease in just a few days. The result can be total blindness.

With partial atrophy of the optic nerves, pathological changes reach a certain limit and then stop in development. A person loses sight partially.

With atrophy, visual function is impaired. Fields of vision may narrow (peripheral vision disappears), tunnel vision may appear, the patient may perceive colors inadequately, dark spots may appear before the eyes. On the affected side, the pupil stops responding to light.

The so-called blind or dark spots are a typical manifestation of optic nerve atrophy. Often, patients complain that they see dark spots before their eyes.

Secondary atrophy can manifest itself in different ways. One of the common causes of the secondary process is tabes. This is a late manifestation of syphilis, in which many organs and systems are affected. Also, the disease can manifest itself due to paralysis, which progresses. Fields of vision begin to narrow, visual function suffers greatly.

If the cause is sclerosis of the carotid artery, the patient develops hemianopsia - blindness of half of the visual field. After profuse bleeding, with unfavorable development, blindness can also occur. It is characterized by the fact that the lower fields of vision fall out.

To find out exactly whether it is atrophy, you need to undergo a complete examination by an ophthalmologist.

Atrophy in children

If there are suspicions that the child has a visual impairment, he must be examined by an ophthalmologist. It is extremely important to identify such a lesion at an early stage, then the prognosis will be as favorable as possible.

The development of atrophy in children is often associated with a hereditary factor. It is also caused by intoxication, inflammation of the brain tissues, their swelling, damage to the eyeball, pathology of pregnancy, problems with the National Assembly, tumors, hydrocephalus, injuries, etc.

Manifestation in children

It is difficult to identify such a serious pathology in a child, especially when it comes to infants. All hope for the vigilance of doctors. They are able to identify the pathology in the first days of the child's life during the examination. Be sure the doctor must examine the pupils of the crumbs, determine how they react to light, how the eyes follow the movement of the object.

If the pupil does not react to light, is dilated, and the child does not follow the object, this is considered a bone sign of the presence of a pathological process.

It is important for parents to respond in time to the onset of symptoms and immediately show the child to an ophthalmologist. Untimely treatment or its absence can lead to partial or complete blindness.

congenital atrophy

This form is the most difficult to treat. It accompanies many congenital pathological syndromes.

If atrophy is detected, the doctor must establish its degree, cause, find out how damaged the nerve fiber is.

If we talk about the diagnosis of children, then it is complicated by the fact that the child cannot tell about his subjective sensation or visual impairment. This is where preventive care comes into play. They will help to identify the pathology at an early stage.

It is also important that the parents themselves carefully monitor the state of the child. It is they who can notice that the child began to behave unusually, stopped responding to movement around the periphery, looks closely at objects, bumps into them, etc.

Treatment of optic nerve atrophy in children is not much different from getting rid of pathology in adults. The drugs and their doses can only differ. In some cases, emergency surgery is indicated. Among drugs, it is important to use those that improve blood circulation, constrict blood vessels. Along with them, vitamins, drugs to stimulate metabolic processes are prescribed.

Diagnostics

At first glance, this diagnosis leaves no chance of restoring vision, but this is a delusion. In four cases out of five, vision can be restored at least partially. During the diagnosis, the ophthalmologist must definitely find out what concomitant diseases the patient has, whether he is taking medication, whether he can come into contact with chemicals, whether he has bad habits. All this can cause damage to the optic nerve.

Visually, the doctor can determine whether the patient's eyeball is protruding, whether it is mobile (the patient must look down, up, left, right), how correctly the pupils react, and whether there is a corneal reflex. He must check visual acuity, color perception, perimeter.

The main diagnostic method is ophthalmoscopy. It helps to examine the optic nerve disc in detail, to find out if it has turned pale, if its contours and color are blurred. The number of small vessels on the disk may decrease, the caliber of the arteries on the retina may narrow, and the veins may change. To confirm or refute the diagnosis, tomography can additionally be used.

With EVP (electrophysiological examination), the doctor may detect increased sensitivity of the optic nerve. If we are talking about glaucomatous form, the doctor can use a tonometer.

Plain radiography is used to study the orbit. Doppler ultrasound is used to study blood flow. Often, additional consultations with a neurologist, x-ray of the skull, MRI, CT scan of the brain are required. If a neoplasm of the brain, increased intracranial pressure was detected, a consultation with a neurosurgeon will also be needed.

Consultation with a rheumatologist is required for systemic vasculitis. With tumors of the orbit, the help of an ophthalmo-oncologist is needed. If damage to large blood vessels is detected, you need to contact a vascular surgeon, an ophthalmologist. If there is a suspicion that an infection is present, PCR and ELISA tests are prescribed.

It is important to exclude amblyopia, peripheral cataract, as their symptoms are very similar to signs of atrophy.

Treatment

If atrophy of the optic nerve is detected, the treatment rests solely with the ophthalmologist. At his disposal are many modern methods of treatment and quite effective drugs. The main thing is not to get rid of the atrophy itself, as a consequence, but to fight its cause.

Attempts to treat such a serious pathology at home with the help of dubious folk remedies look sad. The patient thus loses precious time and chances for recovery. It is impossible to get rid of optic nerve atrophy if its cause is not eliminated!

Most often, optic nerve atrophy is not an independent disease, but a consequence of the development of some pathological process. Diseases, including infectious ones, can lead to atrophy. Infections quickly damage the optic nerve. Injuries, dysfunction of large vessels, genetic abnormalities, autoimmune lesions, etc. are also dangerous.

If it is precisely established that the cause is a tumor, hypertension, neurosurgical intervention is performed. A successful operation will save the patient's vision, and in some cases life.

With conservative treatment, every effort should be made to preserve the remaining vision as much as possible. The treatment regimen is selected exclusively by an ophthalmologist. Sometimes he works with other specialists.

It is very important to ensure the removal of infiltrate during the inflammatory process, improve blood circulation, the state of blood vessels, and nerve trophism. It is necessary to monitor the indicators of intraocular pressure.

To maximize the effect of the treatment, the doctor may prescribe acupuncture, physiotherapy, magnetotherapy.

If vision falls below 0.01, treatment will not be effective.

Forecast

What will be the prognosis of treatment is affected by how timely it is started and adequately selected. It is extremely important to start it at the earliest stage of development of the pathological process. With a favorable course, vision can not only be restored, but even slightly improved. But it should be understood that it will not be possible to completely restore it.

If the atrophy is progressive, even with very active treatment, it can end in complete blindness.

Prevention

This pathology largely depends on the attitude of a person to his health. Often, the death of the tissues of the optic nerve manifests itself as a complication after the flu, acute respiratory viral infections, it often happens at a late stage in the development of syphilis.

It is extremely important to take care of the timely prevention of such a dangerous pathology. It is necessary to treat eye, endocrine, neurological, infectious diseases, inflammatory processes in the body in time. Since intoxication is very dangerous, poisoning should be avoided, work with chemicals carefully, and do not drink alcoholic beverages.

In the event of profuse bleeding, it is necessary to immediately provide a blood transfusion of the desired group.

It is important to immediately consult an ophthalmologist in case of visual impairment.

So, atrophy of the optic nerve is not so common. The current level of development of medicine, ophthalmology, can quite successfully deal with this disease. With proper treatment, partially visual functions can be restored. It is important not only to choose the right drugs and take them according to the prescribed scheme, but also to eliminate the cause that led to atrophy.

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.

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

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

According to the degree of visual impairment, atrophy can be partial or complete. According to research data, it can be seen that men suffer from partial atrophy of the optic nerve in 57.5%, and women in 42.5%. Most often there is a bilateral lesion (in 65% of cases).

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

Etiology and classification

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

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

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

Processes that damage the fibers of the optic nerve at various levels (orbit, optic canal, cranial cavity) lead to descending acquired atrophy. The nature of the damage is different: inflammation, trauma, glaucoma, toxic damage, circulatory disorders in the vessels that feed the optic nerve, metabolic disorders, compression of the optic fibers by a volumetric formation in the orbital cavity or in the cranial cavity, degenerative process, myopia, etc.).

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

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

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

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

Diagnostics

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

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

Physical examination :

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

Laboratory research

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

Instrumental Research

• visometry: visual acuity can range from 0.7 to practical blindness. With damage to the papillomacular bundle, visual acuity is significantly reduced; with a slight lesion of the papillomacular bundle and involvement in the process of peripheral nerve fibers of the ON, visual acuity decreases slightly; with damage only to peripheral nerve fibers - does not change. ·
• refractometry: the presence of refractive errors will allow a differential diagnosis with amblyopia.
• Amsler test - distortion of lines, blurring of the pattern (damage to the papillomacular bundle). ·
• perimetry: central scotoma (with damage to the papillomacular bundle); various forms of narrowing of the visual field (with damage to the peripheral fibers of the optic nerve); with damage to the chiasma - bitemporal hemianopsia, with damage to the visual tracts - homonymous hemianopsia. With damage to the intracranial part of the optic nerve, hemianopsia occurs in one eye.
  • Kinetic perimetry for colors - narrowing of the field of view to green and red, less often to yellow and blue.
  • Computer perimetry - determination of the quality and quantity of cattle in the field of view, including 30 degrees from the point of fixation.
• dark adaptation study: dark adaptation disorder. Color vision study: (Rabkin's tables) - a violation of color perception (increased color thresholds), more often in the green-red part of the spectrum, less often in the yellow-blue.
• tonometry: an increase in IOP is possible (with glaucomatous atrophy of the optic nerve).
• biomicroscopy: on the side of the lesion - an afferent pupillary defect: a decrease in direct pupillary reaction to light while maintaining a friendly reaction of the pupil.
• ophthalmoscopy:
  • initial atrophy of the optic nerve disc - against the background of the pink coloration of the optic disc, blanching appears, which later becomes more intense.
  • partial atrophy of the optic nerve - blanching of the temporal half of the optic nerve, Kestenbaum's symptom (decrease in the number of capillaries on the optic disc from 7 or less), arteries are narrowed,
  • incomplete atrophy of the optic nerve - uniform blanching of the optic nerve, Kestenbaum's symptom is moderately pronounced (a decrease in the number of capillaries on the optic nerve disc), the arteries are narrowed,
  • complete atrophy of the optic nerve - total blanching of the optic nerve, the vessels are constricted (the arteries are narrowed more than the veins). Kestenbaum's symptom is sharply expressed (a decrease in the number of capillaries on the optic disc - up to 2-3 or capillaries may be absent).

In primary atrophy of the ONH, the borders of the ONH are clear, its color is white, grayish-white, bluish or slightly greenish. In redless light, the contours remain clear, while the contours of the optic disk normally become fuzzy. In red light with atrophy of the optic disc - blue. With secondary atrophy of the ONH, the borders of the ONH are fuzzy, blurry, the ONH is gray or dirty gray, the vascular funnel is filled with connective or glial tissue (in the long term, the borders of the ONH become clear).

• Optical coherence tomography of the ONH (in four segments - temporal, superior, nasal and inferior): reduction in the area and volume of the neuroretinal rim of the ONH, a decrease in the thickness of the nerve fiber layer of the optic disc and in the macula.
• Heidelberg retinal laser tomography - a decrease in the depth of the optic nerve head, the area and volume of the neuroretinal rim, an increase in the excavation area. With partial atrophy of the optic nerve, the depth range of the optic nerve head is less than 0.52 mm, the rim area is less than 1.28 mm 2 , the excavation area is more than 0.16 mm 2 .
• fluorescein angiography of the fundus: hypofluorescence of the optic disc, narrowing of the arteries, absence or decrease in the number of capillaries on the optic disc;
• electrophysiological studies (visual evoked potentials) - a decrease in the amplitude of the VPV and a lengthening of the latency. In case of damage to the papillomacular and axial bundle of optic nerves, electrical sensitivity is normal, in case of violation of peripheral fibers, the threshold of electrical phosphene is sharply increased. Lability is especially sharply reduced in axial lesions. During the progression of the atrophic process in the ON, the retino-cortical and cortical time increases significantly;
• USDG of the vessels of the head, neck, eyes: decreased blood flow in the ophthalmic, supratrochlear artery and intracranial part of the internal carotid artery;
• MRI of cerebral vessels: foci of demyelination, intracranial pathology (tumors, abscesses, brain cysts, hematomas);
• MRI of the orbit: compression of the orbital part of the ON;
• Radiography of the orbit according to Riese - a violation of the integrity of the optic nerve.

Differential Diagnosis

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

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

Atrophy of the optic nerve can be observed with deformities and diseases of the bones of the skull. Such atrophy is observed with a tower-shaped skull. Visual impairment usually develops in early childhood and rarely after 7 years of age. Blindness in both eyes is rare, sometimes there is blindness in one eye with a sharp decrease in vision in the other eye. From the side of the field of view, there is a significant narrowing of the boundaries of the field of view along all meridians, there is no cattle. Atrophy of the optic nerve with a tower-shaped skull is considered by most to be a consequence of congestive nipples that develop on the basis of increased intracranial pressure. Of the other deformities of the skull, atrophy of the optic nerves is caused by dysostosis craniofacialis (Cruson's disease, Apert's syndrome, marble disease, etc.).

Atrophy of the optic nerve can be in case of poisoning with quinine, plasmacide, fern in the expulsion of worms, lead, carbon disulfide, botulism, in case of poisoning with methyl alcohol. Methyl alcohol atrophy of the optic nerve is not so rare. After the use of methyl alcohol, after a few hours, paralysis of accommodation and dilation of the pupils appear, a central scotoma occurs, and vision is sharply reduced. Then vision is partially restored, but atrophy of the optic nerve gradually increases and irreversible blindness sets in.

Atrophy of the optic nerve can be congenital and hereditary, with birth or postpartum head injuries, prolonged hypoxia, etc.

Treatment

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

In the treatment of partial atrophy of the optic nerve, as a rule, pharmacotherapy is used. The use of drugs makes it possible to influence various links in the pathogenesis of optic nerve atrophy. But do not forget about the methods of physiotherapy and various ways of administering drugs. The issue of optimizing the routes of administration of drugs is also relevant in recent years. Thus, parenteral (intravenous) administration of vasodilators can contribute to systemic vasodilation, which, in some cases, can lead to steal syndrome and worsen blood circulation in the eyeball. The fact of a greater therapeutic effect with topical application of drugs is generally accepted. However, in diseases of the optic nerve, local application of drugs is associated with certain difficulties caused by the existence of a number of tissue barriers. The creation of a therapeutic concentration of the drug in the pathological focus is achieved more successfully with a combination of drug therapy and physiotherapy.

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

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

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

Indications for consultation of narrow specialists:

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

Treatment effectiveness indicators:

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

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

Causes of optic nerve atrophy

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

In the case of degeneration of fibers in any of the departments of the optic nerve, its ability to transmit signals to the brain is impaired.

Regarding the causes of AD, scientific studies have established that:

• Approximately 2/3 of the cases were bilateral.
• Intracranial neoplasms are the most common cause of bilateral AD.
• The most common cause of unilateral injury is traumatic brain injury.
• Vascular factors are a common cause of AD in people over 40 years of age.

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

Consider the most common causes of AD:

1. Primary diseases affecting the optic nerve: chronic glaucoma, retrobulbar neuritis, traumatic optic neuropathy, formations that compress the optic nerve (eg, tumors, aneurysms).
2. Primary diseases of the retina, for example, occlusion of the central artery or central retinal vein.
3. Secondary diseases of the optic nerve: ischemic optic neuropathy, chronic neuritis or edema of the optic nerve.

Less common causes of AD:

1. Hereditary optic neuropathy (for example, Leber's optic neuropathy).
2. Toxic neuropathy, which can be caused by exposure to methanol, certain drugs (disulfiram, ethambutol, isoniazid, chloramphenicol, vincristine, cyclosporine, and cimetidine), alcohol and tobacco abuse, metabolic disorders (eg, severe renal failure).
3. Retinal degeneration (for example, retinitis pigmentosa).
4. Retinal storage diseases (eg, Tay-Sachs disease)
5. radiation neuropathy.
6. Syphilis.

Classification of optic nerve atrophy

There are several classifications of ADS.

According to the pathological classification, ascending (anterograde) and descending (retrograde) atrophy of the optic nerve is distinguished.

The ascending ADS looks like this:

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

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

According to the ophthalmoscopic classification, there are:

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

According to the degree of damage to the nerve fibers, there are:

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

Symptoms of optic nerve atrophy

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

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

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

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

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

In children, a recent history of flu-like symptoms or recent vaccination suggests parainfectious or post-vaccination optic neuritis.

Diplopia and facial pain suggest multiple cranial nerve neuropathy seen in inflammatory or neoplastic lesions of the posterior orbit and the anatomical region around the sella turcica.

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

Diagnosis of optic nerve atrophy

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

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

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

How to treat optic nerve atrophy?

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

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

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

• Treatment of descending optic nerve atrophy caused by an intracranial tumor or hydrocephalus is aimed at eliminating compression of the nerve fibers by the neoplasm.
• In the case of inflammatory diseases of the optic nerve (neuritis) or ischemic neuropathy, intravenous corticosteroids are used.
• With toxic neuropathy, antidotes are prescribed for those substances that caused damage to the optic nerves. In the event that atrophy is caused by drugs, their administration is stopped or the dose is adjusted.
• Neuropathy due to nutritional deficiencies is treated with dietary modifications and the administration of multivitamin preparations that contain micronutrients necessary for good vision.
• With glaucoma, conservative treatment is possible, aimed at lowering intraocular pressure, or performing a surgical operation.

In addition, there are methods of physiotherapy, magnetic, laser and electrical stimulation of the optic nerve, which are aimed at the maximum possible preservation of the functions of nerve fibers.

There are also scientific works that have shown the effectiveness of the treatment of AD with the introduction of stem cells. With the help of this still experimental technique, it is possible to partially restore vision.

Prognosis for ASD

The optic nerve is part of the central rather than peripheral nervous system, which makes it impossible to regenerate after damage. Thus, AD is irreversible. Treatment of this pathology is aimed at slowing down and limiting the progression of the degeneration process. Therefore, every patient with optic nerve atrophy should remember that the only place where you can cure this pathology or stop its development is the ophthalmology departments in medical institutions.

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

Prevention

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

Atrophy of the optic nerve is a consequence of the degeneration of its fibers. It can be caused by many diseases, from glaucoma and circulatory disorders (ischemic neuropathy) to inflammation (eg, multiple sclerosis) and nerve-compressing masses (eg, intracranial tumors). Effective treatment is possible only at the stage of partial atrophy of the optic nerve. The choice of method of therapy depends on etiological factors. In this regard, it is necessary to establish the correct diagnosis in time and direct all efforts to preserve vision.

Useful video about optic nerve atrophy