Optic nerve atrophy (optic neuropathy) is partial or complete destruction of the nerve fibers that transmit visual stimuli from the retina to the brain. During atrophy, the nervous tissue experiences an acute lack of nutrients, which is why it ceases to perform its functions. If the process continues long enough, the neurons begin to gradually die. Over time, it affects an increasing number of cells, and in severe cases, the entire nerve trunk. It will be almost impossible to restore eye function in such patients.

What is the optic nerve?

The optic nerve belongs to the cranial peripheral nerves, but essentially it is not a peripheral nerve either in origin, structure, or function. This is the white matter of the cerebrum, the pathways that connect and transmit visual sensations from the retina to the cerebral cortex.

The optic nerve delivers nerve messages to the area of ​​the brain responsible for processing and perceiving light information. It is the most important part of the entire process of converting light information. Its first and most significant function is the delivery of visual messages from the retina to the areas of the brain responsible for vision. Even the smallest injuries to this area can have serious complications and consequences.

Optic atrophy according to the ICD has ICD code 10

Reasons

The development of optic nerve atrophy is caused by various pathological processes in the optic nerve and retina (inflammation, dystrophy, edema, circulatory disorders, toxins, compression and damage to the optic nerve), diseases of the central nervous system, general diseases of the body, hereditary causes.

The following types of disease are distinguished:

• Congenital atrophy - manifests itself at birth or a short period of time after the birth of the child.
• Acquired atrophy is a consequence of adult diseases.

Factors leading to optic nerve atrophy may include eye diseases, central nervous system lesions, mechanical damage, intoxication, general, infectious, autoimmune diseases, etc. Optic nerve atrophy appears as a result of obstruction of the central and peripheral retinal arteries that supply the optic nerve, as well as is the main symptom of glaucoma.

The main causes of atrophy are:

• Heredity
• Congenital pathology
• Eye diseases (vascular diseases of the retina, as well as the optic nerve, various neuritis, glaucoma, pigmentary degeneration of the retina)
• Intoxication (quinine, nicotine and other drugs)
• Alcohol poisoning (more precisely, alcohol surrogates)
• Viral infections (flu, flu)
• Pathology of the central nervous system (brain abscess, syphilitic lesion, skull injury, multiple sclerosis, tumor, syphilitic lesion, skull injury, encephalitis)
• Atherosclerosis
• Hypertension
• Profuse bleeding

The cause of primary descending atrophy is vascular disorders with:

• hypertension;
• atherosclerosis;
• spinal pathologies.

Secondary atrophy is caused by:

• acute poisoning (including alcohol substitutes, nicotine and quinine);
• inflammation of the retina;
• malignant neoplasms;
• traumatic injury.

Optic nerve atrophy can be caused by inflammation or dystrophy of the optic nerve, its compression or trauma, leading to damage to the nerve tissue.

Types of disease

Atrophy of the optic nerve of the eye occurs:

• Primary atrophy(ascending and descending), as a rule, develops as an independent disease. Descending optic atrophy is most often diagnosed. This type of atrophy is a consequence of the fact that the nerve fibers themselves are affected. It is transmitted in a recessive manner by inheritance. This disease is linked exclusively to the X chromosome, which is why only men suffer from this pathology. It manifests itself at 15-25 years of age.
• Secondary atrophy usually develops after the course of any disease, with the development of stagnation of the optic nerve or a violation of its blood supply. This disease develops in any person and at absolutely any age.

In addition, the classification of forms of optic nerve atrophy also includes the following variants of this pathology:

Partial optic atrophy

A characteristic feature of the partial form of optic nerve atrophy (or initial atrophy, as it is also defined) is the incomplete preservation of visual function (vision itself), which is important when visual acuity is reduced (due to which the use of lenses or glasses does not improve the quality of vision). Although residual vision can be preserved in this case, disturbances in color perception are noted. Preserved areas within sight remain accessible.

Complete atrophy

Any self-diagnosis is excluded - only specialists with the proper equipment can make an accurate diagnosis. This is also due to the fact that the symptoms of atrophy have much in common with amblyopia and cataracts.

In addition, optic nerve atrophy can manifest itself in a stationary form (that is, in a complete form or a non-progressive form), which indicates a stable state of actual visual functions, as well as in the opposite, progressive form, in which a decrease in the quality of visual acuity inevitably occurs.

Symptoms of atrophy

The main sign of optic nerve atrophy is a decrease in visual acuity that cannot be corrected with glasses and lenses.

• With progressive atrophy, a decrease in visual function develops over a period of several days to several months and can result in complete blindness.
• In the case of partial atrophy of the optic nerve, pathological changes reach a certain point and do not develop further, and therefore vision is partially lost.

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

Alarming symptoms that may indicate that optic nerve atrophy is developing are:

• narrowing and disappearance of visual fields (lateral vision);
• the appearance of “tunnel” vision associated with color sensitivity disorder;
• the occurrence of scotomas;
• manifestation of the afferent pupillary effect.

The manifestation of symptoms can be unilateral (in one eye) or multilateral (in both eyes at the same time).

Complications

The diagnosis of optic atrophy is very serious. At the slightest decrease in vision, you should immediately consult a doctor so as not to miss your chance of recovery. Without treatment and as the disease progresses, vision may disappear completely, and it will be impossible to restore it.

To prevent the occurrence of pathologies of the optic nerve, it is necessary to carefully monitor your health and undergo regular examinations by specialists (rheumatologist, endocrinologist, neurologist, ophthalmologist). At the first signs of vision deterioration, you should consult an ophthalmologist.

Diagnostics

Optic nerve atrophy is a fairly serious disease. In case of even the slightest decrease in vision, it is necessary to visit an ophthalmologist so as not to miss precious time for treating the disease. Any self-diagnosis is excluded - only specialists with the proper equipment can make an accurate diagnosis. This is also due to the fact that the symptoms of atrophy have much in common with amblyopia and.

An examination by an ophthalmologist should include:

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

Also, a certain information content is achieved to compile a general picture of the disease through laboratory research methods, such as blood tests (general and biochemical), testing for or for syphilis.

Treatment of optic nerve atrophy of the eye

Treatment of optic atrophy is a very difficult task for doctors. You need to know that destroyed nerve fibers cannot be restored. One can hope for some effect from treatment only by restoring the functioning of nerve fibers that are in the process of destruction, which still retain their vital activity. If this moment is missed, then vision in the affected eye can be lost forever.

When treating optic nerve atrophy, the following actions are performed:

1. Biogenic stimulants (vitreous body, aloe extract, etc.), amino acids (glutamic acid), immunostimulants (Eleutherococcus), vitamins (B1, B2, B6, ascorutin) are prescribed to stimulate the restoration of altered tissue, and are also prescribed to improve metabolic processes
2. Vasodilators are prescribed (no-spa, diabazole, papaverine, sermion, trental, zufillin) to improve blood circulation in the vessels supplying the nerve
3. To maintain the functioning of the central nervous system, Fezam, Emoxipin, Nootropil, Cavinton are prescribed
4. To accelerate the resorption of pathological processes - pyrogenal, preductal
5. Hormonal drugs are prescribed to stop the inflammatory process - dexamethasone, prednisolone.

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

Patients who have completely lost their vision or have lost it to a significant extent are prescribed an appropriate course of rehabilitation. It is aimed at compensating and, if possible, eliminating all the restrictions that arise in life after suffering optic nerve atrophy.

Basic physiotherapeutic methods of therapy:

• color stimulation;
• light stimulation;
• electrical stimulation;
• magnetic stimulation.

To achieve a better result, magnetic and laser stimulation of the optic nerve, ultrasound, electrophoresis, and oxygen therapy can be prescribed.

The earlier treatment is started, the more favorable the prognosis of the disease. Nervous tissue is practically irreparable, so the disease cannot be neglected; it must be treated in a timely manner.

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

The prognosis for optic nerve atrophy is always serious. In some cases, you can expect to preserve your vision. If atrophy develops, the prognosis is unfavorable. Treatment of patients with optic atrophy, whose visual acuity has been less than 0.01 for several years, is ineffective.

Prevention

Optic atrophy is a serious disease. To prevent it, you need to follow some rules:

• Consultation with a specialist if there is the slightest doubt about the patient’s visual acuity;
• Prevention of various types of intoxication
• promptly treat infectious diseases;
• do not abuse alcohol;
• monitor blood pressure;
• prevent eye and traumatic brain injuries;
• repeated blood transfusion for profuse bleeding.

Timely diagnosis and treatment can restore vision in some cases, and slow or stop the progression of atrophy in others.

Optic atrophy is a disease in which vision decreases, sometimes to the point of complete loss. This occurs when the nerve fibers that carry information about what a person sees from the retina to the visual part of the brain partially or completely die. This pathology can arise due to many reasons, so 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 stop the loss of visual function and restore it. If the nerve has completely atrophied, 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 visible to a person is read from the retina and transmitted to the visual department, where it is already transformed into a familiar image. When atrophy occurs, the nerve fibers begin to die and are replaced by connective tissue, which is similar to scar tissue. In this condition, the functioning of the capillaries supplying the nerve stops.

How is the disease classified?

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

1. ascending - the layer of nerve fibers located on the retina of the eye is affected, and the lesion itself is sent to the brain;
2. descending - the visual part of the brain is affected, and the lesion is directed to the disc 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 widespread, but vision is not completely lost;
• complete – the optic nerve dies, leading to complete loss of visual function.

With a unilateral disease, one nerve is damaged, as a result of which one eye begins to see poorly. When the nerves of both eyes are damaged, they speak of bilateral atrophy. According to the stability of visual function, the pathology can be stationary, in which visual acuity falls and then remains 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 ophthalmological nature. Nerve death can occur due to:

• compression of the vessels supplying the nerve or the nerve itself by a neoplasm in the skull;
• myopia;
• atherosclerosis, leading to plaques in blood vessels;
• thrombosis of nerve vessels;v
• inflammation of the vascular walls during syphilis or vasculitis;
• disturbances in the structure of blood vessels due to diabetes mellitus or increased blood pressure;
• eye injury;
• intoxication of the body during respiratory viral infections, when consuming 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 atrophy:

1. retrobulbar neuritis;
2. traumatic damage to the place where the optic nerves cross;
3. 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 suffer from atrophy at once due to:

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

What clinical picture does the disease have?

Symptoms of optic atrophy depend on the form of the disease. If this disease occurs, vision cannot be corrected with glasses. The most basic symptom is decreased visual acuity. The second symptom is a change in the fields of visual function. By this sign, the doctor can understand how deep the lesion has occurred.

The patient experiences “tunnel vision,” that is, the person sees as he would see if he put a tube to his eye. Peripheral (side) 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 the color green, then red.

When nerve fibers concentrated as close as possible to the retina or directly in it are damaged, dark spots appear in the center of the visible image. With a deeper lesion, half the image on the side of the nose or temple may disappear, depending on which side the lesion occurs on. With secondary atrophy caused by any ophthalmological disease, the following symptoms occur:

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

Important! If even slight clouding appears in the eye (or both eyes), you should visit an ophthalmologist as soon as possible. Only by detecting the disease in time can you stop it at the stage of partial atrophy and restore vision without allowing complete atrophy.

What are the features of pathology in children

With the congenital form of the disease, it can be determined that the baby’s pupils do not react well to light. As the child grows up, parents may notice that he does not respond to an object brought to him from a certain direction.

Important! A child under two or three years old cannot report that he sees poorly, and older children, whose problem is congenital, may not realize that they can see differently. That is why it is necessary for the child to be examined annually by an ophthalmologist, even if there are no symptoms visible to the parent.

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

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

How is the disease diagnosed?

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

• X-ray of the skull;
• magnetic resonance imaging;
• angiography of eye vessels;
• 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 occurred. You may also need to consult related specialists.

How is optic atrophy treated?

How to treat optic nerve atrophy should be decided by the doctor based on the research conducted. It is immediately worth noting that the treatment of this disease is very difficult, because nerve tissue regenerates very poorly. It is necessary to carry out complex systematic therapy, which should take into account the cause of the pathology, its duration, the age of the patient, and his general condition. If some process occurring inside the skull (for example, a tumor or inflammation) has led to the death of the nerve, then treatment should begin with a neurosurgeon and neuropathologist.

Treatment with medications

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

• vasodilators - No-Shpa 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, spruce atrophy has an infectious bacterial pathogenesis.

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

Microsurgical treatment is aimed at eliminating compression of the nerve, as well as increasing the diameter of the vessels that feed it. Conditions can also be created in which new blood vessels can grow. Surgery can only help with partial atrophy; if the nerves die 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 wooliflora;
• small periwinkle;
• hawthorn (flowers and fruits);
• chokeberry;
• Baikal skullcap (root);
• Daurian black cohosh;
• grandiflora magnolia (leaves);
• swampy dryweed.

Blueberries are good for vision; they contain many vitamins, as well as an anthocyanoside, which has 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 put it in the refrigerator. This mixture is taken in half a glass for a month. The course must be repeated twice a year, which will be beneficial even with good vision.

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

1. Chinese lemongrass leaves;
2. zamanika roots;
3. Leuzea;
4. ginseng;
5. Eleutherococcus;
6. sea ​​buckthorn (fruits and pollen).

If incomplete necrosis of the nerves occurs or senile degenerative changes occur in the eyes, then it is necessary to take anti-sclerotic plants:

1. orange;
2. cherry;
3. hawthorn;
4. cabbage;
5. corn;
6. seaweed;
7. dandelion;
8. chokeberry;
9. garlic and onion.

Carrots (contain a lot of carotene) and beets (rich in zinc) have beneficial properties.

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, it leads to disability due to complete blindness.

In order to prevent the necrosis of nerve fibers, ophthalmological diseases, as well as endocrine, neurological, infectious and rheumatological diseases should be treated in a timely manner. Very important in prevention is the prevention of intoxication damage to the body.

Anatomically and functionally, the organ of vision is not limited to the eyes. With the help of their structures, signals are perceived, and the image itself is formed in the brain. The connection between the perceptive part (retina) and the visual nuclei in the brain is carried out through the optic nerves.

Accordingly, atrophy of the optic nerve is the basis for the loss of normal vision.

Anatomy

On the side of the eyeball, the formation of nerve fibers occurs from long processes of retinal ganglion cells. Their axons intertwine at a place called the optic disc (ONH), located at the posterior pole of the eyeball a few millimeters closer to the center. The nerve fibers are accompanied by the central retinal artery and vein, which together move through the optic canal into the interior of the skull.

Functions

The main function of the nerve is to conduct signals from retinal receptors, which are processed in the occipital cortex of the brain.

A feature of the structure of the human visual analyzer is the presence of the optic chiasm - a place where the nerves from the right and left eyes are partially intertwined with their parts closest to the center.

Thus, part of the image from the nasal region of the retina is translated to the opposite region in the brain, and from the temporal region it is processed by the hemisphere of the same name. As a result of combining images, the right visual fields are processed in the visual area of ​​the left hemisphere, and the left ones - in the right.

Damage to the optic nerves always affects the visual field

Determination of ongoing processes

Degeneration can occur along the entire length of the nerve, at the decussation and further along the optic tracts. This type of damage is called primary atrophy; the optic disc becomes pale or silvery-white in color, but retains its original size and shape.

The causes of optic nerve atrophy lie in the formation of optic disc edema from increased intracranial pressure, impaired evacuation of venous blood and lymph. The formation of congestion is accompanied by blurring of the disc boundaries, an increase in size, and protrusion into the vitreous body. The arterial vessels of the retina are narrowed, and the venous ones become dilated and tortuous.

Prolonged stagnation leads to atrophy of the optic disc. It decreases sharply, the boundaries become clearer, the color is still pale. This is how secondary atrophy is formed. It is noteworthy that in the state of a stagnant disc, vision is still preserved, but during the transition to atrophy it sharply decreases.

Acquired dystrophy

Acquired nerve atrophies have an intraocular or descending cause.

Eye diseases include intraocular hypertension, spasm of supply vessels, their atherosclerosis, microthrombosis, consequences of hypertension, toxic damage from methyl alcohol, ethambutol, quinine.

In addition, compression of the optic disc is possible in the presence of a tumor, hematoma in the eye, or its edema. This can be caused by chemical poisoning, eye injury, or an infectious abscess in the area where the optic nerve exits.

Among the inflammatory causes, I most often name iritis and cyclitis. Catarrh of the iris and ciliary body is accompanied by changes in intraocular pressure and the structure of the vitreous body, thereby affecting the state of the optic disc.

Descending atrophy of the optic nerve is caused by inflammatory diseases of the meninges (meningitis, arachnoencephalitis), neurological lesions of the brain (demyelinating diseases, multiple sclerosis, consequences of infectious diseases or damage to toxins, hydrocephalus).

Atrophy can develop from compression by a tumor, hematoma, abscess along the nerve outside the eye, its inflammatory disease - neuritis

Congenital optic atrophy

The process of atrophy begins even before the birth of the child. It is caused by the presence of intrauterine diseases of the central nervous system or is hereditary.

Optic nerve atrophy in children, inherited in a dominant manner, affecting both eyes, is more common than others and is called juvenile atrophy. Violations appear by the age of 20.

Infantile congenital dystrophy is inherited as a recessive trait. It appears in newborns in the first few years of life. This is complete permanent atrophy of the optic nerves of both eyes, which leads to a sharp decrease in vision and a concentric narrowing of the fields.

Sex-linked and complicated Beer's atrophy also appears early (before three years of age). In this case, vision suddenly decreases, after which the disease constantly progresses. With partial atrophy of the optic nerve, the outer halves of the disc are the first to be affected, then complete atrophy occurs in combination with other neurological manifestations - strabismus and nystagmus. In this case, the peripheral field of vision may be preserved, but the central one may be absent.

Leber optic atrophy usually shows its first ocular signs starting at the age of five. It begins suddenly and acutely, in many ways reminiscent of neuritis that develops in one eye, and after a month to six months, in the second.

Distinctive features:

• nyctalopia - twilight vision is better than daylight vision;
• insufficiency of color vision in red and green colors;
• hyperemia of the fundus, the boundaries of the disc are slightly blurred;
• loss of the central visual field with preservation of the peripheral ones.

With atrophy, changes appear a couple of months after the onset of the disease. First of all, the optic disc in the temporal region suffers, then optic nerve atrophy develops.

Congenital atrophy can also include optodiabetic syndrome - damage to the optic disc on the background of diabetes mellitus or diabetes insipidus in combination with hydronephrosis, defects of the genitourinary system, and deafness.

Symptoms

• Typically, atrophy is accompanied by a progressive deterioration in visual function.
• Scotoma is an area of ​​blindness in the visual field that is not associated with a physiological blind spot. Usually it is surrounded by a field with normal acuity and preservation of all light-sensitive cells.
• The ability to perceive colors is impaired.
• In this case, partial atrophy of the optic nerve can occur with preservation of visual acuity.
• With a descending path of development due to a brain tumor, specific symptoms of atrophy may be observed - Foster-Kennedy syndrome. On the part of the tumor, primary atrophy of the optic nerve head occurs and nerve atrophy occurs as a secondary phenomenon in the opposite eye.

Consequences of atrophy

Impaired conduction of visual signals due to complete atrophy of the optic nerve leads to absolute blindness in the corresponding eye. In this case, the reflex adaptation of the pupil to light is lost. It is able to react only in concert with the pupil of a healthy eye, which is tested by directed light.

Partial atrophy of the optic nerve will be reflected in sector-by-sector loss of vision in the form of separate islands.

Do not confuse the concepts of subatrophy of the optic nerve and subatrophy of the eyeball. In the latter case, the entire organ sharply decreases in size, shrinks and does not imply the function of vision at all. Such an eye must be removed surgically. The operation is necessary both to improve the patient’s appearance and to remove from the body a body that is now foreign to it, which can become a target for autoimmune reactions and cause an immune attack on the healthy eye. Atrophy of the eyeball is the irreversible loss of the organ of vision.

In the case of nerve subatrophy, it implies partial dysfunction and the possibility of conservative treatment, but without restoration of visual acuity

Damage to the optic nerve at the site of the chiasm causes complete bilateral blindness and leads to disability.

Treatment

Many people hope to cure optic nerve atrophy by looking for “miraculous” folk methods. I would like to draw attention to the fact that this condition is considered difficult to treat in official medicine. Treatment of optic nerve atrophy with folk remedies will most likely have a general strengthening and supportive effect. Decoctions of herbs, flowers, and fruits are unable to restore atrophied nerve fiber, but can be sources of vitamins, microelements, and antioxidants.

• an infusion of pine needles, rose hips and onion peels, prepared from a liter of water and plant materials in a ratio of 5:2:2.
• infusion of forest mallow and burdock with the addition of primrose, lemon balm and dolnik.
• infusion of rue herb, unripe pine cones, lemon, prepared in a sugar solution - 0.5 cups of sand per 2.5 liters of water.

Modern methods of treating this condition are based on a complex of therapeutic measures.

Drug treatment

First of all, efforts are made to restore blood circulation and nutrition to the nerve, stimulating its viable part. Vasodilators, anti-sclerotic drugs and medications that improve microcirculation, multivitamins and biostimulants are prescribed.

A breakthrough in the treatment of optic atrophy is associated with the use of nanotechnology, which involves delivering a drug directly to the nerve with nanoparticles.

Traditionally, most drugs are administered as an injection under the conjunctiva or retrobulbar - A; irrigation system – B

The prognosis for treatment of partial optic nerve atrophy in children is most favorable, since the organs are still in the process of growth and development. Irrigation therapy has a good effect. A catheter is installed in the retrobulbar space, through which the drug can be administered regularly and many times without damaging the child’s psyche.

Irreversible changes in nerve fibers prevent vision from being fully restored, so achieving a reduction in the area of ​​death is also a success.

Treatment of secondary optic nerve atrophy will bear fruit with simultaneous treatment of the underlying disease.

Physiotherapy

Along with medications, physiotherapeutic methods can also significantly improve the condition of the nerve fiber, normalize metabolic processes and blood supply.

Today, treatment methods using magnetic, electrical, and laser stimulation of the optic nerve are known; ultrasound pulses and oxygen therapy can also be used. Forced stimulation of the nerve helps to initiate normal processes of excitation and conduction, but with a large amount of atrophy, the nerve tissue is not restored.

Surgical intervention

This type of treatment can be considered in the context of removing a tumor or other formation that is compressing the optic nerve.

On the other hand, microsurgical restoration of the nerve fiber itself is gaining increasing popularity.

The newest methods include stem cell treatment. They can integrate into damaged tissue and further stimulate its repair by secreting neurotrophic and other growth factors.

Regeneration of nerve tissue occurs extremely rarely. The speed of recovery is crucial in maintaining its functionality, so it is important to seek medical help promptly if you suspect optic nerve atrophy, so as not to lose your vision.

The optic nerve (ocular nerve) is a nerve that connects the eye to the gray matter through the nuclei of the diencephalon. This is not a nerve in the usual sense, which is a chain of neurons connected by axons - long processes, but rather a white medulla located outside the skull.

The structure of the optic nerve is a thick bundle of neurons intertwined with the ophthalmic vein and artery, extending directly into the cerebral cortex through the diencephalon. Considering that a person has 2 eyes, he also has 2 optic nerves - 1 for each eye, respectively.

Like any nerve, it is prone to specific diseases and disorders, collectively called neuralgia and neuritis. Neuralgia is a disease that is a long-term painful reaction of the nerve to any irritants without changing the internal structure. And neuritis is the destruction or damage of the nerve fiber under various influences.

Visual neuralgia practically does not occur in humans, since its structure transmits visual signals, analyzing them along the way, which explains its similarity to the brain matter, and other fibers are responsible for tactile or pain sensations. Even if a person develops neuralgia directly from the main optic trunk, he most likely simply will not notice it, which cannot be said about neuralgia of the outgoing lateral branches.

Neuritis is a violation of the structure of the nerve fiber or its damage in some area. In half of the cases, neuralgia turns into neuritis, and in the other, the damage is caused by very real physical reasons, which will be discussed a little later. Optic neuritis is most often called optic atrophy.

The classification of optic atrophy includes: primary, secondary, complete, progressive, partial, complete, bilateral and unilateral, subatrophy, ascending and descending and others.

• Initial, when only a couple of fibers are damaged.
• Progressive atrophy is atrophy that continues to progress despite attempts to stop the disease.
• Completed - a disease that has stopped at some stage.
• Partial atrophy of the optic nerve is partial destruction of the nerve tissue, while maintaining one or another lobe of vision, sometimes referred to as PAZN.
• Complete – the nerve is completely atrophied and restoration of vision is impossible.
• Unilateral – damage to one eye, and bilateral, respectively – damage to the nerves of both eyes.
• Primary – not associated with other diseases, for example, toxic damage from burnt alcohol.
• Secondary - atrophy, manifested as a complication after an illness, for example, inflammation of the eyeball, membranes of the brain and other tissues.
• Subatrophy of the optic nerve is an uneven damage to neurons, as a result of which the perceived information is distorted.
• Ascending atrophy is a neuronal disorder that begins in the retina and gradually moves upward.
• Descending optic atrophy is a disease that begins in the brain and gradually spreads to the eyes.
• Neuropathy is a dysfunction of the nerve fiber without signs of inflammation.
• Neuritis is inflammation of the optic nerve with pain caused by smaller adnexal optic nerve endings, or the area around the main optic nerve.

In the medical literature there is some confusion in the concepts of neuritis, neuropathy and atrophy of the optic nerves: somewhere it is said that these are one and the same thing, and somewhere that these are three completely different diseases. However, they certainly have a common essence, symptoms and treatment.

If the definition of neuritis is very broad - a violation of the structure of the nerve, which includes many disorders and inflammations for completely different reasons, then atrophy and neuropathy are more likely to be subtypes of neuritis, and not vice versa.

In medical terminology in the ICD (medical classification of diseases, the latest of which is ICD 10), there are many different names for essentially the same process, depending on the degree of severity, characteristics of the course, method of acquisition, etc. this allows doctors to convey information to each other more informatively, and it is quite difficult for the patient to understand all the intricacies of terminology.

Optic nerve atrophy code according to ICD 10 is H47.2, as indicated in the sick leave certificate, medical reference books or in the patient’s card. The international code is used to maintain medical confidentiality from ignorant strangers. The tenth version of the ICD is the most recent.

Optic nerve atrophy symptoms

Symptoms of optic nerve atrophy look like a rapid decline in vision that cannot be corrected or corrected. The process that has begun can very quickly lead to absolute, incorrigible blindness from just a few days to several months, depending on the cause and severity of the disease.

Signs of optic atrophy may appear as changes in vision without loss of visual acuity. That is:

• Vision becomes tunnel-like.
• Changes in visual fields, most often towards their uniform narrowing.
• The presence of permanent, unchanging dark spots before the eyes.
• Asymmetric change in visual fields. For example: the side one remains, but the central one disappears.
• Distortion of color perception or sensitivity to light.

The type of vision change depends on which area is affected, so the appearance of so-called scotomas (dark spots) indicates damage in the central part of the retina, and narrowing of the fields - in the peripheral fibers.

Diagnostics

If a diagnosis of optic nerve atrophy is suspected, diagnosis is carried out primarily by an ophthalmologist, to whom patients come with the first vision problems. The ophthalmologist first conducts a study to separate this disease from peripheral cataracts, as well as amblyopia, which have similar manifestations.

The initial examination carried out to establish a diagnosis is quite simple: examination for acuity with a wide field of view and ophthalmoscopy.

During ophthalmoscopy (a painless examination of the eye itself through a special apparatus directly in the office at the reception), the optic disc is visible; if it turns pale, it means it is atrophied or damaged. If the boundaries of the disc are smooth and normal, the disease is primary, and if the boundaries are violated, it is a secondary consequence of another disease.

Checking the reaction of the pupils: with impaired sensitivity, the pupils contract much more slowly when exposed to light.

After confirming the diagnosis, a neurologist joins the treatment and begins to determine the causes of the degenerative process:

• General tests for inflammatory processes, as well as viral infections.
• Tomography.
• Radiography.
• electrophysiological study (EPS) – study of the functioning of all eye systems by recording reactions to special impulses.
• fluorescein angiographic method is a study by introducing a special marker substance into the blood and using it to check the vascular conductivity of the eye.

Causes of the disease

For this diagnosis of optic nerve atrophy, the causes can be so diverse that it is possible to compose an entire scientific treatise on medicine, however, a small circle of the main, most common ones is highlighted.

• Toxic blindness:

Toxic atrophy of the optic nerve, the causes of which lie in the death of neurons under the influence of poisons. In the nineties in Russia, the first place was toxic damage to visual neurons under the influence of burnt alcohol or even liquids not intended for internal use containing methyl alcohol. It is almost impossible for a non-specialist to distinguish methyl alcohol from ethyl alcohol, however, unlike its cheerful brother, this substance is extremely dangerous to life.

Just 40 to 250 ml of methanol can cause death or very severe disability if resuscitation measures are carried out in time. In order for neurons to die, only 5 to 10 milliliters is enough, even in a mixture with other substances. When it is used, not only the optic nerves die, however, this is not as noticeable to the patient as a sudden loss of vision. In addition, toxic blindness often begins after a long period of time - up to six days after consumption, when methanol breaks down in the liver into its components, one of which is formaldehyde - a terrible poison. By the way, smoking products are also toxic to neurons.

• Congenital pathologies.

For congenital or hereditary reasons, optic nerve atrophy in children occurs most often due to neglect of the child’s health during the mother’s pregnancy or a genetic failure.

• Injuries.

Atrophy caused by blows to the head or injuries to the eyeball, as well as brain surgery.

• Inflammation.

The inflammatory process that leads to the death of visual neurons can occur for many reasons, either simply because of a speck that got into the eye, causing inflammation of the eyeball, or because of previous infectious diseases: meningitis (infectious inflammation of the brain), measles, chickenpox, smallpox, syphilis, encephalitis (viral brain damage), mononucleosis, sinusitis, tonsillitis and even caries.

• General pathologies of the patient’s entire nervous system.
• Damage to the eye that provoked nerve atrophy as unnecessary, for example, retinal dystrophy. These two diseases intensify and accelerate each other.
• Circulatory disorders.

The disease can cause both obstruction of the supply vessels and their atherosclerosis, high blood pressure or damage with hemorrhage

• Oncology.

All kinds of tumors with abscesses in the brain compress the nerve itself, destroy the area to which it sends a signal, provoke malfunctions in the functioning of the entire neural system, causing complications in the eyes or even appearing directly in the eyeball.

• Other diseases: glaucoma, hypertension, atherosclerosis, diabetes, allergic reactions, lack of vitamins or their excess, autoimmune disorders and many others.

Treatment of optic neuritis

Treatment of optic nerve atrophy is carried out by two doctors at once - an ophthalmologist and a neurologist, and in large cities there are neuro-ophthalmological centers specializing in such ailments. Treatment is always carried out inpatiently and urgently already at the stage of a preliminary unconfirmed diagnosis, since the disease is incredibly transient and a person can lose his sight in just a few days.

Can optic nerve atrophy be cured? It is impossible to completely cure the disease. Treatment comes down to stopping the spread of damage and trying to normalize the functioning of surviving neurons as much as possible.

This occurs because neurons lack the ability to divide. The vast majority of neurons in the human nervous system are formed in the mother’s tummy, and increase slightly as the child develops. Neurons themselves cannot divide, their number is strictly limited, new neurons are built only from bone marrow stem cells, which represent the body’s stabilization fund, which has a strictly limited number of cells - lifesavers, laid down during the period of embryonic development and slowly consumed in the process of life. An additional complication is that stem cells can turn into neurons only by forming new chaotic connections, and are unable to become patches for the damaged tissue. This principle of operation is good for renewing the brain, but the body will repair a separate nerve by simply replacing the dead nerve cells with connective tissue cells, which perfectly fill any cellular bald spots in the human body, but are not capable of performing any functions.

Currently, experiments are underway with stem cells obtained from embryos killed during abortions or miscarriages, which give excellent results in the rejuvenation and restoration of various tissues, including nerves, however, in reality this method is not used because it is too fraught with cancer, such as which doctors have not yet figured out to treat.

The place where atrophy can be cured is exclusively in a hospital; in this case, even outpatient (home) treatment is not allowed, during which precious seconds may be lost.

Treatment with folk remedies is not only unacceptable, but simply does not exist. In folk medicine there are no such rigorous effective means for accurate diagnosis and very quick treatment.

With complete or partial atrophy of the optic nerve, treatment begins with diagnosing the causes of the disease, after which the attending physician selects an appropriate course, including surgical intervention.

In addition to the use of special means, the patient is often prescribed a biogenic stimulant, aloe extract, which prevents the replacement of body tissues with connective cells. This drug is given in injections after any operation or after inflammation of the appendages in women as an anti-adhesion drug.

All kinds of pinching, compression, tumors, vascular aneurysms near the optic nerve and other similar causes of atrophy are removed surgically.

The inflammatory process caused by the consequences of an infectious infection is stopped using antibiotics or antiviral and anti-inflammatory drugs.

Toxic visual atrophy. the nerve is treated by removing toxins or neutralizing them, stopping further destruction of neurons. The antidote to methyl alcohol is food grade ethyl alcohol. So, in case of poisoning, it is necessary to rinse the stomach with a solution of sodium bicarbonate (sold in a pharmacy, not to be confused with sodium bicarbonate - baking soda), drink a 30-40% solution, for example, high-quality vodka, in an amount of 100 milliliters and repeat after 2 hours, halving the volume.

Dystrophy and other retinal disorders are treated with ophthalmological methods: laser surgery, vitamin or drug courses, depending on the cause. If the nerve begins to atrophy due to unnecessary use, then it will soon begin to recover after the retina is restored.

Congenital and genetic optic nerve atrophy in children is corrected based on the type of pathology and often surgically.

In addition to specific treatment based on the cause of the disease, treatment includes immunostimulation, vasodilation, biogenic stimulation, hormonal drugs to prevent even the slightest hint of inflammation (prednisolone, dexamethasone), drugs that accelerate resorption (pyrogenal, preductal), some means of maintaining work of the nervous system (emoxipin, fezam, etc.), physiotherapy, laser, electrical or magnetic stimulation of the optic nerve.

At the same time, the body is urgently saturated with vitamins, minerals and nutrients. At this stage, lovers of traditional medicine can choose a remedy to their liking from strengthening, immunostimulating and anti-inflammatory agents. It is only important not to act in secret from the doctor, because everything the patient uses must be correctly combined with a huge number of prescribed drugs, otherwise you risk losing not only your sight, but also your life.

Such a huge set of procedures, sometimes taking more than a year, is necessary not to restore vision, but simply to stop its loss.

Optic nerve atrophy in a child

Optic nerve atrophy in a child is a rather rare disease, characteristic of older people and practically no different from the same disease in an adult. The main difference is that in young children, neurons are still able to partially recover and in the initial stages it is quite possible not only to stop the disease, but also to reverse it. An exception is hereditary atrophy of the optic nerve in children, the treatment of which has not yet been found - Liberov atrophy, transmitted through the male line.

Possible consequences and forecasts

Should I panic after hearing such a diagnosis? At the initial stages there is no particular reason for panic; at this time the disease is quite easily controlled. And neurons that are not severely damaged even restore their functions. With improper treatment, self-medication and an irresponsible attitude, there is another possible outcome: in addition to vision, in some cases a person can lose his life, since the optic nerve is very large and is directly connected to the brain. Along it, like a bridge, inflammation from the eye can easily spread to brain tissue and cause irreversible consequences. It is even more dangerous when atrophy is caused by inflammation of the brain itself, tumors or problems with blood vessels. Complete or partial atrophy of the optic nerves may also occur, with atrophy of the optic nerve (main trunk).

When the first symptoms occur, you need to remember that a person builds his own future, and his correct actions will determine whether he will be healthy, whether his vision will be restored, whether the normal functioning of the entire nervous system of the body will be maintained, or whether he will prefer to spend invaluable time on not the most important things. activities, for example, being afraid to leave work, trying to save on treatment by ignoring some prescriptions, or wasting time on long-term rehabilitation.

The second pair of cranial nerves is the most important element of the visual system, because through it the connection between the retina and the brain occurs. Although other structures continue to function correctly, any deformation of the nervous tissue affects the properties of vision. Optic nerve atrophy cannot be cured without leaving a trace; nerve fibers cannot be restored to their original state, so it is better to carry out prevention in a timely manner.

Basic information on the disease

Optic atrophy or optic neuropathy is a severe process of destruction of axons (nerve tissue fibers). Extensive atrophy thins the nerve column, healthy tissue is replaced by glial tissue, and small vessels (capillaries) are blocked. Each of the processes causes certain symptoms: visual acuity decreases, various defects appear in the visual field, and the shade of the optic nerve head (OND) changes. All pathologies of the optic nerves account for 2% of the statistics of eye diseases. The main danger of optical neuropathy is absolute blindness, which occurs in 20-25% of people with this diagnosis.

Optic neuropathy does not develop on its own; it is always a consequence of other diseases, so a person with atrophy is examined by different specialists. Typically, optic nerve atrophy is a complication of a missed ophthalmological disease (inflammation in the structures of the eyeball, swelling, compression, damage to the vascular or nervous network).

Causes of Optic Neuropathy

Despite the many causes of optic nerve atrophy known to medicine, in 20% of cases they remain unclear. Usually these are ophthalmological pathologies, central nervous system diseases, autoimmune disorders, infections, injuries, intoxications. Congenital forms of ADN are often diagnosed together with cranial defects (acrocephaly, microcephaly, macrocephaly) and hereditary syndromes.

Causes of optic nerve atrophy from the visual system:

• neuritis;
• arterial obstruction;
• myopia;
• retinitis;
• oncological lesion of the orbit;
• unstable eye pressure;
• local vasculitis.

Injury to nerve fibers can occur during a traumatic brain injury or even the mildest injury to the facial skeleton. Sometimes optic neuropathy is associated with the growth of meningioma, glioma, neuroma, neurofibroma and similar formations in the thickness of the brain. Optical disturbances are possible with osteosarcoma and sarcoidosis.

Causes from the central nervous system:

• neoplasms in the pituitary gland or cranial fossa;
• compression of chiasmata;
• multiple sclerosis.

Atrophic processes in the second pair of cranial nerves often develop as a result of purulent-inflammatory conditions. The main danger is brain abscesses, inflammation of its membranes.

Systemic risk factors

• diabetes mellitus;
• atherosclerosis;
• anemia;
• avitaminosis;
• hypertension;
• antiphospholipid syndrome;
• Wegener's granulomatosis;
• systemic lupus erythematosus;
• giant cell arteritis;
• multisystem vasculitis (Behcet's disease);
• nonspecific aortoarteritis (Takayasu disease).

Read also: Danger and prognosis of the optic nerve.

Significant nerve damage is diagnosed after prolonged fasting, severe poisoning, or massive blood loss. Alcohol and its surrogates, nicotine, chloroform and some groups of medications have a negative effect on the structures of the eyeball.

Optic nerve atrophy in a child

Half of all cases of optic neuropathy in children are caused by inflammatory infections of the central nervous system, brain tumors, and hydrocephalus. Less commonly, the state of destruction is caused by deformation of the skull, cerebral anomalies, infections (mainly “children’s”), and metabolic disorders. Particular attention should be paid to congenital forms of childhood atrophy. They indicate that the baby has brain diseases that arose during prenatal development.

Classification of optical neuropathy

All forms of optic nerve atrophy are hereditary (congenital) and acquired. Congenital diseases are divided according to the type of inheritance; they often indicate the presence of genetic abnormalities and hereditary syndromes that require in-depth diagnosis.

Hereditary forms of ADS

1. Autosomal dominant (juvenile). Predisposition to nerve destruction is transmitted in a heterogeneous manner. The disease is usually detected in children under 15 years of age; it is recognized as the most common, but weakest form of atrophy. It is always bilateral, although sometimes the symptoms appear asymmetrically. Early signs are detected by 2-3 years, and functional disorders only at 6-20 years. Possible combination with deafness, myopathy, ophthalmoplegia and distance.
2. Autosomal recessive (infantile). This type of ADN is diagnosed less frequently, but much earlier: immediately after birth or during the first three years of life. The infantile form is bilateral in nature and is often detected in Kenny-Coffey syndrome, Rosenberg-Chattorian, Jensen or Wolfram disease.
3. Mitochondrial (Leber's atrophy). Mitochondrial optic atrophy is the result of a mutation in mitochondrial DNA. This form is considered a symptom of Leber's disease; it occurs suddenly and resembles external neuritis in the acute phase. Most patients are men 13-28 years old.

Forms of acquired atrophy

• primary (squeezing the neurons of the peripheral layers, the optic disc does not change, the boundaries have a clear appearance);
• secondary (swelling and enlargement of the optic disc, unclear boundaries, replacement of axons by neuroglia is quite pronounced);
• glaucomatous (destruction of the cribriform plate of the sclera due to surges in local pressure).

Destruction can be ascending, when the axons of the cranial nerves are affected, and descending, involving the nerve tissue of the retina. According to symptoms, they distinguish between unilateral and bilateral ADN, according to the degree of progression - stationary (temporarily stable) and in constant development.

Types of atrophy according to the color of the optic disc:

• initial (slight blanching);
• incomplete (noticeable blanching of one segment of the optic disc);
• complete (change in shade over the entire area of ​​the optic disc, severe thinning of the nerve pillar, narrowing of the capillaries).

Symptoms of optic atrophy

The degree and nature of optical disturbances directly depends on which nerve segment is affected. Visual acuity can decrease critically very quickly. Complete destruction ends in absolute blindness, pallor of the optic disc with white or gray spots, and narrowing of the capillaries in the fundus. With incomplete ONH, vision stabilizes at a certain time and no longer deteriorates, and the pallor of the ONH is not so pronounced.

If the fibers of the papillomacular bundle are affected, the deterioration in vision will be significant, and the examination will show a pale temporal zone of the optic disc. In this case, optical disorders cannot be corrected with glasses or even contact lenses. Damage to the lateral zones of the nerve does not always affect vision, which complicates diagnosis and worsens the prognosis.

ADN is characterized by various visual field defects. The following symptoms allow one to suspect optic neuropathy: concentric narrowing, effect, weak pupillary reaction. In many patients, the perception of colors is distorted, although more often this symptom develops when axons die after neuritis. Often the changes affect the green-red part of the spectrum, but its blue-yellow components can also be distorted.

Diagnosis of optic atrophy

The expressive clinical picture, physiological changes and functional disorders greatly simplify the diagnosis of ADN. Difficulties may arise when actual vision does not match the degree of destruction. To make an accurate diagnosis, the ophthalmologist must study the patient’s medical history, establish or deny the fact of taking certain medications, contact with chemical compounds, injuries, and bad habits. Differential diagnosis is carried out for peripheral lens opacification and amblyopia.

Ophthalmoscopy

Standard ophthalmoscopy allows one to establish the presence of ADN and accurately determine the extent of its spread. This procedure is available in many regular clinics and does not cost much. The results of the study may vary, but some signs are detected in any form of neuropathy: changes in the shade and contour of the optic disc, a decrease in the number of vessels, narrowing of the arteries, and various venous defects.

Ophthalmoscopic picture of optical neuropathy:

1. Primary: clear disc boundaries, optic disc sizes are normal or reduced, saucer-shaped excavation is present.
2. Secondary: grayish tint, blurred disc borders, enlarged optic disc, no physiological excavation, peripapillary reflex to light sources.

Coherence tomography

Optical coherence or laser scanning tomography allows us to study the nerve disc in more detail. Additionally, the degree of mobility of the eyeballs is assessed, the reaction of the pupils and the corneal reflex are checked, they are carried out with tables, visual field defects are examined, color vision is checked, and eye pressure is measured. Visually, the ophthalmologist determines the presence.

Plain radiography of the orbit allows you to identify pathologies of the orbit. Fluorescein angiography shows dysfunction of the vasculature. To study local blood circulation, Doppler ultrasound is used. If atrophy is due to infection, laboratory tests such as enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR) are performed.

Electrophysiological tests play a key role in confirming the diagnosis. Optic nerve atrophy changes the threshold sensitivity and lability of the nervous tissue. The rapid progression of the disease increases retino-cortical and cortical time.

The level of reduction depends on the location of the neuropathy:

• when the papillomacular bundle is destroyed, sensitivity remains at a normal level;
• damage to the periphery causes a sharp increase in sensitivity;
• atrophy of the axial fascicle does not change sensitivity, but sharply reduces lability.

If necessary, check the neurological status (x-ray of the skull, CT or MRI of the brain). When a patient is diagnosed with a brain tumor or unstable intracranial pressure, a consultation with an experienced neurosurgeon is prescribed. In case of orbital tumors, it is necessary to include an ophthalmic oncologist in the course. If destruction is associated with systemic vasculitis, you need to contact a rheumatologist. Pathologies of the arteries are dealt with by an ophthalmologist or vascular surgeon.

How is optic atrophy treated?

The treatment regimen for each patient with optic neuropathy is always individual. The doctor needs to get all the information about the disease in order to create an effective plan. People with atrophy require immediate hospitalization, while others are able to maintain outpatient treatment. The need for surgery depends on the causes of ASD and symptoms. Any therapy will be ineffective if vision weakens to 0.01 units or below.

It is necessary to begin treatment of optic nerve atrophy by identifying and eliminating (or stopping) the root cause. If cranial nerve damage is caused by intracranial tumor growth, an aneurysm, or unstable cranial pressure, neurosurgery must be performed. Endocrine factors influence hormonal levels. Post-traumatic compression is corrected surgically by removing foreign bodies, removing chemicals, or limiting hematomas.

Conservative therapy for optical neuropathy is primarily aimed at inhibiting atrophic changes, as well as preserving and restoring vision. Drugs are indicated to expand the vasculature and small vessels, reducing capillary spasm and accelerating blood flow through the arteries. This allows all layers of the optic nerve to be supplied with sufficient nutrients and oxygen.

Vascular therapy for ADN

• intravenously 1 ml of nicotinic acid 1%, glucose for 10-15 days (or orally 0.05 g three times a day after meals);
• Nikoshpan tablet three times a day;
• intramuscularly 1-2 ml No-shpa 2% (or 0.04 g orally);
• intramuscularly 1-2 ml of Dibazol 0.5-1% daily (or orally 0.02 g);
• 0.25 g of Nihexin three times a day;
• subcutaneously 0.2-0.5-1 ml of sodium nitrate of increasing concentration 2-10% in a course of 30 injections (increase every three injections).

Decongestants are needed to reduce swelling, which helps reduce compression of the nerve and blood vessels. Anticoagulants are used to prevent thrombosis; the vasodilator and anti-inflammatory Heparin is recognized as the best. It is also possible to prescribe antiplatelet agents (prevention of thrombosis), neuroprotectors (protection of nerve cells), glucocorticosteroids (combat inflammatory processes).

Conservative treatment of ADN

1. To reduce inflammation in the nervous tissue and relieve swelling, dexamethasone solution is prescribed in the eye, intravenous glucose and calcium chloride, and intramuscular diuretics (Furosemide).
2. Strychnine nitrate solution 0.1% in a course of 20-25 subcutaneous injections.
3. Parabulbar or retrobulbar injections of Pentoxifylline, Atropine, xanthinol nicotinate. These drugs help speed up blood flow and improve trophism of nervous tissue.
4. Biogenic stimulants (FIBS, aloe preparations) in a course of 30 injections.
5. Nicotinic acid, sodium iodide 10% or Eufillin intravenously.
6. Vitamins orally or intramuscularly (B1, B2, B6, B12).
7. Antioxidants (glutamic acid).
8. Orally Cinnarizine, Riboxin, Piracetam, ATP.
9. Instillation of Pilocarpine to reduce eye pressure.
10. Nootropic drugs (Lipocerebrin).
11. Drugs with antikinin effect (Prodectin, Parmidin) for symptoms of atherosclerosis.

In addition to medications, physical therapy is prescribed. Oxygen therapy (use of oxygen) and blood transfusion (urgent blood transfusion) are effective for ADN. During the recovery process, laser and magnetic procedures are prescribed; electrical stimulation and electrophoresis (administration of drugs using electric current) are effective. If there are no contraindications, acupuncture (use of needles on active points of the body) is possible.

Surgical treatment of optic neuropathy

One of the methods of surgical treatment of the optic nerves is hemodynamic correction. The procedure can be performed under local anesthesia: a collagen sponge is placed in the sub-Tenon's space, which stimulates aseptic inflammation and dilates blood vessels. In this way, it is possible to provoke the growth of connective tissue and new vascular network. The sponge dissolves on its own after two months, but the effect lasts for a long time. The operation can be performed repeatedly, but at intervals of several months.

New branches in the vascular network help improve blood supply to nerve tissue, which stops atrophic changes. Correction of blood flow allows you to restore vision by 60% and eliminate up to 75% of visual field defects if you go to the clinic in a timely manner. If the patient has severe concomitant disorders or atrophy has developed to a late stage, even hemodynamic correction will be ineffective.

For partial atrophy of the optic nerve, the use of a collagen implant is practiced. It is impregnated with antioxidants or drugs to dilate capillaries, and then injected into the eyeball without stitches. This method is effective only when eye pressure is stable. The operation is contraindicated in patients over 75 years of age, with diabetes mellitus, severe somatic disorders and inflammation, and vision less than 0.02 diopters.

Prognosis for optic nerve atrophy

To prevent AD, it is necessary to regularly check the condition of those organs that regulate the functioning of the visual system (central nervous system, endocrine glands, joints, connective tissue). In severe cases of infection or intoxication, as well as severe bleeding, urgent symptomatic treatment must be carried out.

It is impossible to completely restore your vision after neuropathy even in the best clinic. A case is considered successful when the patient’s condition has stabilized, ASD does not progress for a long time, and vision has been partially restored. Many people have permanently reduced visual acuity and also have defects in lateral vision.

Some forms of atrophy continually progress even with adequate treatment. The ophthalmologist’s task is to slow down atrophic and other negative processes. Having stabilized the symptoms, it is necessary to constantly prevent ischemia and neurodegeneration. To do this, long-term maintenance therapy is prescribed, which helps improve the blood lipid profile and prevent the formation of blood clots.

The course of treatment for optic nerve atrophy must be repeated regularly. It is very important to eliminate all factors that can affect the optic nerve axons. A patient with optic neuropathy should regularly visit specialists as indicated. It is necessary to constantly prevent complications and improve lifestyle. Refusal of therapy for optical neuropathy inevitably leads to disability due to total death of nerves and irreversible blindness.

Any changes in the layers of the optic nerve negatively affect a person's ability to see. Therefore, it is necessary to undergo timely examinations for people with a predisposition and treat all diseases that contribute to optic nerve atrophy. Therapy will not help restore vision to 100% when optic neuropathy has already developed enough.