Partial and complete optic nerve atrophy: what is it, does it happen in both eyes and how to treat it. Treatment of optic nerve atrophy Compression of the optic nerve

Optic nerve atrophy is a pathological process in which the nerve fibers are partially or completely destroyed and replaced by connective tissue. As a result, dysfunction of the nervous tissue occurs. Most often, atrophy is a complication of some other eye disease.

As the process progresses, neurons gradually die off, as a result of which information coming from the retina of the eye reaches the brain in a distorted form. As the disease progresses, more and more cells die, and ultimately the entire nerve trunk is affected.

In this case, it becomes almost impossible to restore visual function. Therefore, treatment should begin at a very early stage, when the first signs of the disease appear.

How is optic nerve atrophy treated, what are the symptoms of this eye disease? We will talk about all this today on this page “Popular about health” with you. But let's start our conversation with the characteristic signs of this pathology:

Symptoms of eye nerve atrophy

It all starts with decreased vision. This process can occur gradually or rapidly, suddenly. It all depends on the location of the nerve lesion and on which segment of the trunk it develops. Depending on the severity of the pathological process, vision loss is divided into degrees:

Uniform decline. Characterized by a uniform deterioration in the ability to see objects and distinguish colors.

Loss of side margins. A person can clearly distinguish objects in front of him, but he sees poorly or does not see at all what is on the side.

Loss of spots. Normal vision is hampered by a spot in front of the eye, which can have different sizes. Within its limits, a person sees nothing; beyond its limits, vision is normal.

In severe cases of complete atrophy, the ability to see is completely lost.

Treatment of optic atrophy

As we already know, this pathological process is often a complication of another eye disease. Therefore, after identifying the cause, comprehensive treatment of the underlying disease is prescribed and measures are taken to prevent further development of optic nerve atrophy.

In the event that the pathological process has just begun and has not yet developed, it is usually possible to cure the nerve and visual functions are restored within a period of two weeks to several months.

If, by the time treatment begins, atrophy has already developed sufficiently, it is impossible to completely cure the optic nerve, since destroyed nerve fibers cannot yet be restored in our time. If the damage is partial, rehabilitation to improve vision is still possible. But, in the severe stage of complete damage, it is not yet possible to cure atrophy and restore visual functions.

Treatment of eye atrophy involves the use of medications, drops, injections (general and local), the effect of which is aimed at improving blood circulation in the optic nerve, reducing inflammation, as well as restoring those nerve fibers that have not yet been completely destroyed. Additionally, physiotherapy methods are used.

Drugs used in treatment:

To improve blood circulation in the optic nerve, vasodilators are used: Nicotinic acid, No-shpu, Papaverine and Dibazol. Patients are also prescribed Complamin, Eufillin, Trental. And also Galidor and Sermion. For the same purpose, anticoagulant drugs are used: Tiklid and Heparin.

In order to restore metabolic and regenerative processes in the tissues of the affected nerve, patients are prescribed biogenic stimulants, in particular Vitreous Humor, Peat and aloe preparations. Vitamins, amino acids, enzymes and immunostimulants are also prescribed.

To stop and reduce the inflammatory process, hormonal therapy with Prednisolone and Dexamethasone is often used.
In addition, complex treatment includes drugs aimed at normalizing the functioning of the central nervous system: Cerebrolysin, Phezam, as well as Emoxipin, Nootropil and Cavinton.

The doctor prescribes all of the above and other medications individually, after determining the cause of the pathological process and diagnosing the underlying disease. This takes into account the degree of damage to the optic nerve, the patient’s age, his general condition and the presence of concomitant diseases.

In addition to medications, physiotherapeutic techniques and acupuncture are actively used. Methods of magnetic, laser and electrical stimulation of the optic nerve trunk are used. According to indications, the patient may be recommended surgical treatment.

Complex therapy is prescribed in courses that are repeated every few months.

In conclusion of our conversation, it should be noted that optic nerve atrophy cannot be cured by non-traditional means. You will only waste time. The pathological process will progress, increasingly reducing the chances of successful treatment and restoration of vision.

Therefore, if you have the symptoms described above or other symptoms indicating the development of pathology, do not waste precious time and make an appointment with an experienced ophthalmologist. With timely treatment, the chances of restoring vision increase significantly. Be healthy!

Optic nerve atrophy is characterized by the development of the process of complete or partial death of nerve fibers, accompanied by the replacement of healthy connective tissue.

Types of disease

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

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

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

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

Symptoms

If optic atrophy develops, symptoms manifest mainly in the form of deterioration in the quality of vision in both eyes at the same time or in just one. Restoring visual ability in this case is impossible. Depending on the type of pathology, this symptom may have different manifestations.

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

If partial atrophy of the optic nerve is observed, there is a gradual slowdown in progression, after which it completely stops at a certain stage. At the same time, visual activity stops decreasing.

Signs of optic nerve atrophy often appear as: Usually they narrow, which is characterized by loss of lateral vision. This symptom can be almost invisible, but sometimes tunnel vision occurs, that is, when the patient is able to see only those objects that are located directly in the direction of his gaze, as if through a thin tube. Very often, with atrophy, dark, light or colored spots appear before the eyes, and it becomes difficult for a person to distinguish colors.

The appearance of dark or white spots in front of the eyes (both closed and open) indicates that the destruction process is affecting nerve fibers that are located in the central part of the retina or very close to it. Narrowing of the visual fields begins if peripheral nerve tissues have been affected.

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

Causes

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

The appearance of atrophy can be triggered by the development of diseases that directly affect the nerve fibers or the retina of the eye. The following pathological processes can be cited as examples:

mechanical damage (burn or injury) to the retina;
inflammatory processes;
congenital optic nerve dystrophy (OND);
fluid stagnation and swelling;
toxic effects of certain chemicals;
impaired access of blood to nerve tissues;
compression of certain areas of the nerve.

In addition, diseases of the nervous and other body systems play an important role in the development of this pathological process.

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

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

More rare causes are alcohol poisoning of the body and intoxication with other chemicals.

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

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

Diagnostics

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

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

Very often, diagnosis involves the use of the following instrumental methods:

X-ray examination;
magnetic resonance imaging (MRI);
computed tomography of the brain;
electrophysiological diagnostics;
contrast methods (used to determine the patency of retinal vessels).

Laboratory diagnostic methods are mandatory, in particular general and biochemical blood tests.

Treatment options

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

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

In most cases, complex therapy is used, including the use of drugs and optical surgery. Treatment can be carried out with the following medications:

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

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

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

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

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

Surgery is usually prescribed in the presence of neoplasms of various types and hereditary optic nerve atrophy. Surgery is required if there are congenital abnormalities of the visual organ, such as Leber optic atrophy.

Currently, the following surgical methods are used for Leber optic nerve atrophy and other congenital disorders:

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

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

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

Prognosis and prevention

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

Lack of timely treatment can provoke very serious complications that lead not only to decreased vision, but also to its complete loss. In this case, the prognosis is disappointing, since it will no longer be possible to restore visual ability.

In order to prevent the development of this pathological process, the following rules must be observed:

engage in the prevention and timely treatment of any infectious and inflammatory diseases of the body;
prevent mechanical damage to the eye tissue and brain injuries;
periodically undergo examination by a doctor and carry out all necessary diagnostic measures for early detection of diseases;
stop smoking;
remove alcohol from your life;
regularly measure blood pressure;
adhere to proper nutrition;
lead an active lifestyle;
take regular walks in the fresh air.

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

Video

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

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

Classification of optic nerve atrophy

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

Primary atrophy. It occurs due to failures in the nutrition of nerve fibers and circulatory disorders. The disease has an independent nature.
Secondary atrophy. A mandatory factor for the existence of a disease is the presence of other diseases. In particular, these are deviations associated with the optic nerve head.
Congenital atrophy. The body's tendency to develop disease is observed from birth.
Glaucomatous atrophy. Vision remains at a stable level over time. The cause of the disease is vascular insufficiency of the cribriform plate as a result of increased intraocular pressure.
Partial atrophy. Part of the optic nerve is affected, which is where the spread of the disease ends. Vision deteriorates.
Complete atrophy. The optic nerve is completely affected. If the progression of the disease is not stopped, blindness may occur.
Complete atrophy. The deviation has already formed. The spread of the disease stopped at a certain stage.
Progressive atrophy. The rapid development of the atrophic process, which can lead to complete blindness.
Descending atrophy. Irreversible changes in the optic nerves develop slowly.

We see an explanation of how partial atrophy differs from complete atrophy here:

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

Optic nerve atrophy code according to ICD-10

H47.2 Optic atrophy
Pallor of the temporal half of the optic disc

Causes of atrophy

Despite the fact that there are many causes of optic nerve atrophy, in 20% of cases the exact factor as a result of which the disease develops cannot be determined. The most influential causes of atrophy include:

Dystrophy of the retina pigment type.
Inflammation of nerve tissue.
Defects of blood vessels located in the retina.
Increased intraocular pressure.
Spasmodic manifestations related to blood vessels.
Purulent inflammation of brain tissue.
Inflammation of the spinal cord.
Multiple sclerosis.
Infectious diseases (from simple ARVI to more serious diseases).
Malignant or benign tumors.
Various injuries.

Primary descending atrophy can be caused by hypertension, atherosclerosis, or abnormalities in the development of the spine. The causes of the secondary type of disease are poisoning, inflammatory processes and injuries.

Why does atrophy occur in children?

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

Genetic deviation.
Intrauterine and other types of poisoning.
Incorrect course of pregnancy.
Hydrocephalus of the brain.
Deviations in the development of the central nervous system.
Diseases affecting the apple of the eye.
A cranium deformed from birth.
Inflammatory processes in the brain.
Tumor formation.

As we see, the main causes of damage to the nerve cells of the visual organs in children are genetic abnormalities and the mother’s poor lifestyle during pregnancy.

One case of childhood atrophy is presented in this commentary:

Symptoms of the disease

Let's consider the clinical picture for each type of atrophy. The primary form of this disease is characterized by the separation of the boundaries of the nerves of the eye disc, which have acquired a deepened appearance. The arteries inside the eye narrow. In case of a secondary type of disease, the reverse process is noticeable. Nerve boundaries blur and blood vessels dilate.

Congenital atrophy is accompanied by an inflammatory process behind the eyeball. In this case, it is impossible to focus vision without causing discomfort. The resulting image loses the clarity of its lines and looks blurry.

A partial type of disease reaches a certain stage of its development and stops developing. Its symptoms depend on the stage the disease has reached. This form of atrophy may be indicated by partial loss of vision, light flashes before the eyes, images similar to hallucinations, the spread of blind spots and other deviations from the norm.

The following manifestations are considered common signs for all types of optic nerve atrophy::

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

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

Hereditary atrophy. Types and symptoms

Hereditary optic atrophy has several forms of manifestation:

Infantile. Full vision loss occurs between 0 and 3 years of age. The disease is recessive in nature.
Juvenile blindness. The optic disc becomes pale. Vision decreases to 0.1-0.2. The disease develops between 2 and 7 years of age. She is dominant.
Optical-oto-diabetic syndrome. It is detected in the age range from 2 to 20 years. Concomitant diseases - various types of diabetes, deafness, problems with urination, cataracts, pigmented retinal dystrophy.
Beer's syndrome. A serious disease, which is characterized by a decrease in vision in the first year of life to 0.1-0.05. Associated abnormalities include strabismus, symptoms of neurological disorders and mental retardation, damage to the pelvic organs.
Gender-dependent atrophy. In most cases, the disease develops in male children. It begins to manifest itself in early childhood and gradually worsens.
Lester's disease. The age from 13 to 30 years is the period in which the disease occurs in 90% of cases.

Symptoms

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

Diagnosis of optic nerve atrophy

Such studies help to identify the presence of atrophy:

Spheroperimetry – determination of the visual field.
Determination of the degree of visual acuity.
Fundus examination using a slit lamp.
Measuring intraocular pressure.
Computer perimetry helps determine the damaged area of tissue.
Dopplerography using laser equipment shows the characteristics of blood vessels.

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

Treatment of optic atrophy

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

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

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

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

Here is a possible clinical picture of atrophy and its treatment regimen:

A set of medications and physiotherapeutic measures helps speed up the healing process. Treatment is aimed at improving metabolism and blood circulation. Spasms and blood clots that disrupt these processes are eliminated.

Some cases of the disease require the possibility of surgical intervention. A medical drug, the patient’s own tissue or donor materials are placed in the retrobulbar space, which promotes the restoration of damaged areas and the growth of new blood vessels. Surgical installation of an electrical stimulator is also possible. It remains in the orbit of the eye for several years. In most cases of treatment of a disease detected in time, vision can be preserved.

Disease prevention

Measures that will reduce the risk of atrophy to a minimum are a standard list:

Treat infectious diseases in a timely manner.
Eliminate the possibility of injury to the brain and visual organs.
Visit your oncologist regularly to detect cancer early.
Avoid excessive consumption of alcoholic beverages.
Monitor your blood pressure status.

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

Optic nerve atrophy is the development of a pathology in which the optic nerve is partially or completely destroyed within its own fibers, after which these fibers are replaced by connective tissue. Optic nerve atrophy, the symptoms of which are a decrease in visual function in combination with a general blanching of the nerve disc, can be congenital or acquired in the nature of its occurrence.

General description

In ophthalmology, diseases of the optic nerve of one type or another are diagnosed on average in 1-1.5% of cases, while in approximately 26% of them the optic nerve is subject to complete atrophy, which, in turn, causes blindness that cannot be treated. cure. In general, with atrophy, as is clear from the description of the consequences to which it leads, there is a gradual death of its fibers in the optic nerve, followed by their gradual replacement, ensured by connective tissue. This is also accompanied by the conversion of the light signal received by the retina into an electrical signal during its further transmission to the posterior lobes of the brain. Against this background, various types of disorders develop, with a narrowing of the visual fields and a decrease in visual acuity preceding blindness.

Optic nerve atrophy: causes

Congenital or hereditary pathologies directly related to vision that are relevant to the patient can be considered as reasons that provoke the development of the disease we are considering. Optic nerve atrophy can also develop as a result of suffering from any eye diseases or a certain type of pathological process that affects the retina and the optic nerve itself. Examples of the latter factors include eye injury, inflammation, degeneration, congestion, edema, damage caused by toxic effects, compression of the optic nerve, circulatory disorders of one scale or another. In addition, current pathologies with damage to the nervous system, as well as the general type of the disease, also play an important role among the causes.

In frequent cases, the development of optic nerve atrophy is caused by the influence exerted by the pathology of the central nervous system that is relevant to the patient. Such pathologies can be considered syphilitic brain damage, abscesses and brain tumors, meningitis and encephalitis, skull trauma, multiple sclerosis, etc. Alcohol poisoning caused by the use of methyl alcohol and general intoxication of the body are also among the factors affecting the central nervous system , and, ultimately, among the factors provoking optic nerve atrophy.

The development of the pathology we are considering can also be contributed to by diseases such as atherosclerosis and hypertension, as well as conditions the development of which is provoked by vitamin deficiency, quinine poisoning, profuse bleeding and fasting.

In addition to the listed factors, optic nerve atrophy can also develop against the background of obstruction of the peripheral retinal arteries and obstruction of the central artery in it. Due to these arteries, nutrition is provided to the optic nerve; accordingly, if they are obstructed, its functions and general condition are disrupted. It should be noted that obstruction of these arteries is also considered as the main symptom indicating the manifestation of glaucoma.

Optic nerve atrophy: classification

Optic nerve atrophy, as we initially noted, can manifest itself both as a hereditary pathology and as a non-hereditary pathology, that is, acquired. The hereditary form of this disease can manifest itself in such basic forms as the autosomal dominant form of optic atrophy, the autosomal recessive form of optic atrophy, and the mitochondrial form.

Congenital atrophy is considered to be atrophy resulting from genetic diseases that cause visual impairment in the patient from birth. Leber's disease is identified as the most common disease in this group.

As for the acquired form of optic nerve atrophy, it is determined by the peculiarities of the influence of etiological factors, such as damage to the fibrous structure of the optic nerve (which determines such a pathology as descending atrophy) or damage to retinal cells (this, accordingly, determines such a pathology as ascending atrophy) atrophy). The acquired form of optic nerve atrophy can, again, be provoked by inflammation, glaucoma, myopia, metabolic disorders in the body and other factors that we have already discussed above. Acquired optic atrophy can be primary, secondary or glaucomatous.

At the heart of the mechanism primary form of atrophy The optic nerve is considered to be an effect in which compression of peripheral neurons within the visual pathway occurs. The primary form (which is also defined as the simple form) of atrophy is accompanied by clear disc boundaries and pallor, narrowing of the vessels in the retina and the possible development of excavation.

Secondary atrophy, developing against the background of stagnation of the optic nerve or against the background of its inflammation, is characterized by the appearance of signs inherent in the previous, primary form of atrophy, but in this case the only difference is the vagueness of the boundaries, which is relevant for the boundaries of the optic nerve head.

At the heart of the development mechanism glaucomatous form of atrophy The optic nerve, in turn, is considered to be a collapse that has arisen in the sclera from the side of its cribriform plate, which occurs due to a state of increased intraocular pressure.

In addition, the classification of forms of optic nerve atrophy also includes such variants of this pathology as already noted in the general review partial atrophy optic nerve and complete atrophy optic nerve. Here, as the reader can roughly assume, we are talking about the specific degree of scale of damage to nerve tissue.

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, there are disturbances in color perception. Preserved areas within sight remain accessible.

In addition, optic nerve atrophy can manifest itself in stationary form ( that is, in finished form or 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. Depending on the extent of the lesion, optic nerve atrophy manifests itself in both unilateral and bilateral forms (that is, affecting one eye or both eyes at once).

Optic nerve atrophy: symptoms

The main symptom of this disease is, as noted earlier, a decrease in visual acuity, and this pathology cannot be corrected. The manifestations of this symptom may vary depending on the specific type of atrophy. Progression of the disease can lead to a gradual decrease in vision until complete atrophy is achieved, in which vision is completely lost. The duration of this process can vary from several days to several months.

Partial atrophy is accompanied by a stop in the process at a certain stage, after which vision stops falling. According to these features, a progressive or completed form of the disease is distinguished.

With atrophy, vision can be impaired in various ways. Thus, the fields of vision may change (basically they narrow, which is accompanied by the disappearance of the so-called lateral vision), which can lead to the development of a “tunnel” type of vision, in which it seems that everything is seen as if through a tube, in other words, only visibility of objects directly in front of a person. Often scotomas become a companion to this type of vision; in particular, they mean the appearance of dark spots in any part of the visual field. Color vision disorder is also relevant.

Visual fields can change not only according to the type of “tunnel” vision, but also based on the specific location of the lesion. If scotomas, that is, the dark spots noted above, appear in front of the patient’s eyes, this indicates that those nerve fibers that are concentrated in maximum proximity to the central part of the retina or are located directly in it have been affected. The visual fields are narrowed due to damage to the nerve fibers; if the optic nerve is affected at a deeper level, then half of the visual field (nasal or temporal) may disappear. As already noted, the lesion can be either unilateral or bilateral.

Thus, we can summarize the symptoms under the following main points that determine the picture of the course:

the appearance of sector-shaped and central scotomas (dark spots);
decreased quality of central vision;
concentric narrowing of the field of view;
pallor of the optic nerve head.

Secondary optic nerve atrophy determines the following manifestations during ophthalmoscopy:

varicose veins;
vasoconstriction;
smoothing the area of the optic nerve boundaries;
disc blanching.

Diagnosis

Self-diagnosis, as well as self-medication (including treatment of optic nerve atrophy with folk remedies) for the disease in question should be completely excluded. In the end, due to the similarity of the manifestations characteristic of this pathology with manifestations, for example, of a peripheral form of cataract (accompanied initially by impaired lateral vision with subsequent involvement of the central parts) or with amblyopia (a significant decrease in vision without the possibility of correction), it is simply impossible to establish an accurate diagnosis on your own .

What is noteworthy is that even of the listed disease options, amblyopia is not a disease as dangerous as optic nerve atrophy can be for a patient. Additionally, it should be noted that atrophy can also manifest itself not only as an independent disease or as a result of exposure to another type of pathology, but can also act as a symptom of certain diseases, including diseases that end in death. Considering the seriousness of the lesion and all possible complications, it is extremely important to promptly begin diagnosing optic nerve atrophy, to find out the reasons that provoked it, as well as to adequately treat it.

The main methods on which the diagnosis of optic nerve atrophy is based include:

ophthalmoscopy;
visometry;
perimetry;
color vision research method;
computed tomography;
radiography of the skull and sella turcica;
NMR scanning of the brain and orbit;
fluorescein angiography.

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 borelliosis or syphilis.

Treatment

Before moving on to the specifics of the treatment, we note that it in itself is an extremely difficult task, because the restoration of damaged nerve fibers is in itself impossible. A certain effect, of course, can be achieved through treatment, but only under the condition of restoration of those fibers that are in the active phase of destruction, that is, with a certain degree of their vital activity against the background of such exposure. Missing this moment can cause final and irreversible loss of vision.

Among the main areas of treatment for optic nerve atrophy, the following options can be distinguished:

treatment is conservative;
therapeutic treatment;
surgical treatment.

Principles conservative treatment boil down to the sale of the following drugs in it:

vasodilators;
anticoagulants (heparin, ticlid);
drugs whose effect is aimed at improving the general blood supply to the affected optic nerve (papaverine, no-spa, etc.);
drugs that affect metabolic processes and stimulate them in the area of nerve tissue;
drugs that stimulate metabolic processes and have a resolving effect on pathological processes; drugs that stop the inflammatory process (hormonal drugs); drugs that help improve the functions of the nervous system (nootropil, Cavinton, etc.).

Physiotherapeutic procedures include magnetic stimulation, electrical stimulation, acupuncture and laser stimulation of the affected nerve.

The repetition of the course of treatment, based on the implementation of measures in the listed areas of influence, occurs after a certain time (usually within several months).

As for surgical treatment, it implies an intervention aimed at eliminating those formations that compress the optic nerve, as well as ligating the area of the temporal artery and implanting biogenic materials that help improve blood circulation in the atrophied nerve and its vascularization.

Cases of significant loss of vision due to the disease in question necessitate assigning the patient the appropriate degree of impairment to a disability group. Visually impaired patients, as well as patients who have completely lost their vision, are sent to a rehabilitation course aimed at eliminating the restrictions that have arisen in their life activities, as well as compensating for them.

Let us repeat that optic nerve atrophy, which is treated using traditional medicine, has one very significant drawback: when using it, time is lost, which is almost precious as part of the progression of the disease. It is during the period of active independent implementation of such measures by the patient that there is an opportunity to achieve positive and significant results on their own scale due to more adequate treatment measures (and previous diagnostics, by the way, too); it is in this case that the treatment of atrophy is considered as an effective measure in which the return of vision is permissible . Remember that treatment of optic nerve atrophy with folk remedies determines the minimum effectiveness of the effect thus provided!

Update: December 2018

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

Most eye diseases have a fairly favorable course for humans, since modern medicine can cure them or reduce their negative effects 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 timely detection of the cause of the disease and adequate treatment.

What is optic 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, 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.

To understand how this disease manifests itself, it is necessary to imagine the course of impulses to brain structures. They are conventionally divided into two portions – lateral and medial. The first 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 structures of the brain. This path is quite difficult, but there is one fundamental point - almost immediately after leaving the orbit, a crossover occurs in internal portions. What does this lead to?

The left tract perceives the image of the world from the left side of the eyes;
The right one transfers 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 changes in the function of both eyes.

Reasons

In the vast majority of cases, this pathology does not occur independently, but is a consequence of another eye disease. It is very important to consider the cause of optic nerve atrophy, or rather the location of its occurrence. It is this factor that will determine the nature of the patient’s symptoms and the specifics of therapy.

There may be two options:

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

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

Characteristic reasons	Brief description
Ascending type
Glaucoma	This word hides a number of disorders that are united by one feature - increased intraocular pressure. Normally, it is necessary to maintain the correct shape of the eye. But with glaucoma, pressure impedes the flow of nutrients to the nerve tissue and makes them atrophic.
Intrabulbar neuritis	An infectious process that affects neurons in the cavity of the eyeball (intrabulbar form) or behind it (retrobulbar type).
Retrobulbar neuritis
Toxic nerve damage	Exposure to toxic substances in the body leads to the breakdown of nerve cells. The following have a damaging effect on the analyzer: Methanol (a few grams is enough); Combined use of alcohol and tobacco in significant quantities; Industrial waste (lead, carbon disulfide); Medicinal substances in case of increased susceptibility in the patient (Digoxin, Sulfalene, Co-trimoxazole, Sulfadiazine, Sulfanilamide and others).
Ischemic disorders	Ischemia is a lack of blood flow. May occur when: Hypertension of 2-3 degrees (when blood pressure is constantly higher than 160/100 mmHg); Diabetes mellitus (type does not matter); Atherosclerosis – deposition of plaques on the walls of blood vessels.
Stagnant disk	By its nature, this is swelling of the initial part of the nerve trunk. It can occur in any condition associated with increased intracranial pressure: Injuries to the skull area; Meningitis; Hydrocephalus (synonym – “dropsy of the brain”); Any oncological processes of the spinal cord.
Tumors of the nerve or surrounding tissues located before the chiasm	Pathological tissue proliferation can lead to compression of neurons.
Descending type
Toxic lesions (less common)	In some cases, the toxic substances described above can damage neurocytes after crossing.
Tumors of the nerve or surrounding tissues located after the chiasm	Oncological processes are the most common and most dangerous cause of the descending form of the disease. They are not classified as benign, since the difficulties of treatment make it possible to call all brain tumors malignant.
Specific lesions of nervous tissue	As a result of some chronic infections that occur with the destruction of neurocytes throughout the body, the optic nerve trunk may partially/completely atrophy. These specific lesions include: Neurosyphilis; Tuberculosis damage to the nervous system; Leprosy; Herpetic infection.
Abscesses in the cranial cavity	After neuroinfections (meningitis, encephalitis and others), cavities limited by connective tissue walls - abscesses - may appear. If they are located next to the optic tract, there is a possibility of pathology.

Treatment of optic atrophy is closely related to identifying the cause. Therefore, close attention should be paid to clarifying it. Symptoms of the disease, which allow one to distinguish the ascending form from the descending one, can help in diagnosis.

Symptoms

Regardless of the level of damage (above or below the chiasm), there are two reliable signs of optic nerve atrophy - loss of visual fields (“anopsia”) and decreased visual acuity (amblyopia). How pronounced they will be in a particular patient depends on the severity 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? Essentially, this is just an area that a person sees. To imagine it, you can close half of your 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 “lost” one (right or left) zone. This is exactly what anopsia is - the disappearance of the visual field.

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, since 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 certainly appear in the patient.

Which areas will be missing from the patient’s perception? This depends on the level at which the pathological process is located and on the degree of cell damage. There are several options:

Type of atrophy	Damage level	What does the patient feel?
Complete – the entire diameter of the nerve trunk is damaged (the signal is interrupted and is not transmitted to the brain)		The organ of vision on the affected side completely ceases to see
		Loss of right or left visual fields in both eyes
Incomplete - only part of the neurocytes do not perform their function. Most of the image is perceived by the patient	Before the cross (with an ascending form)	There may be no symptoms or the field of vision in one eye may be lost. Which one depends on the location of the atrophy process.
	After the cross (with a descending type)

This neurological symptom seems difficult to perceive, but thanks to it, an experienced specialist can identify the location of the lesion without any additional methods. Therefore, it is very important that the patient speaks openly to their 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:

Mild – characteristic of the initial manifestations of the process. The patient does not feel a decrease in vision, the symptom appears only when carefully examining distant objects;
Medium – occurs when a significant portion of neurons are damaged. Distant objects are practically invisible; at a short distance the patient does not experience any difficulties;
Severe – indicates the activity of the pathology. The sharpness is reduced so much that even objects located nearby become difficult to distinguish;
Blindness (synonymous with amorosis) 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 is aggressive or the patient does not seek help in a timely manner, there is a possibility of developing irreversible blindness.

Diagnostics

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

How is ophthalmoscopy performed?. In the classic version, the fundus is examined by a doctor in a dark room, using a special mirror device (ophthalmoscope) and a light source. The use of modern equipment (electronic ophthalmoscope) allows this study to be carried out with greater accuracy. The patient is not required to have any preparation for the procedure or special actions during the examination.

Unfortunately, ophthalmoscopy does not always detect changes, since symptoms of damage occur earlier than tissue changes. Laboratory tests (blood, urine, cerebrospinal fluid tests) are nonspecific and have only auxiliary diagnostic value.

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

Research method	Principle of the method	Changes in atrophy
Fluorescein angiography (FA)	The patient is injected with a dye through a vein, which enters the blood vessels of the eyes. Using a special device that emits light of different frequencies, the fundus of the eye is “illuminated” and its condition is assessed.	Signs of insufficient blood supply and tissue damage
Laser eye disc tomography (HRTIII)	Non-invasive (remote) way to study the anatomy of the fundus.	Changes in the initial part of the nerve trunk according to the type of atrophy.
Optical coherence tomography (OCT) of the optic disc	Using high-precision infrared radiation, the condition of tissues is assessed.
CT/MRI of the brain	Non-invasive methods for studying the tissues of our body. Allows you to obtain an image at any level, with an accuracy of cm.	Used to determine the possible cause of a disease. As a rule, the purpose of this study is to look for a tumor or other space-occupying formation (abscesses, cysts, etc.).

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

Treatment

There is a widespread belief in society that “nerve cells do not recover.” 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. If the trunk is partially damaged, medications can improve visual acuity and fields. In rare cases, even practically restore the patient's ability to see to normal levels. If the pathological process completely disrupts the transmission of impulses from the eye to the brain, only surgery can help.

To successfully treat this disease, it is necessary, first of all, to eliminate the cause of its occurrence. This will prevent/reduce cell damage and stabilize the course of pathology. Since there are a large number of factors that cause atrophy, doctors' tactics can vary significantly for different conditions. If it is not possible to cure the cause (malignant tumor, hard-to-reach abscess, etc.), you should immediately begin to restore the functionality of the eye.

Modern methods of nerve restoration

Just 10-15 years ago, the main role in the treatment of optic nerve atrophy was given to vitamins and angioprotectors. At present, they have only additional meaning. Medicines that restore metabolism in neurons (antihypoxants) and increase blood flow to them (nootropics, antiplatelet agents and others) come to the fore.

A modern scheme for restoring eye functions includes:

Antioxidant and antihypoxant (Mexidol, Trimetazidine, Trimectal and others) - this group is aimed at tissue restoration, reducing the activity of damaging processes, eliminating “oxygen starvation” of the nerve. In hospital settings, they are administered intravenously; during 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. Also available in the form of solutions for intravenous infusions and tablets;
Nootropics (Piracetam, Cerebrolysin, Glutamic acid) are stimulators of blood flow to neurocytes. 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 administered parabulbarly (a thin needle is passed along the wall of the orbit into the tissue surrounding 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 eye function using peptide bioregulators. At the moment, only two drugs are widely used in specialized centers - Cortexin and Retinalamin. Studies have shown that they improve vision almost twice.

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 - used as injections into the skin of the temples or intramuscularly. The first method is preferable, since it creates a higher concentration of the substance;
Retinalamin - the medicine is injected into the parabulbar tissue.

The combination of classical and peptide therapy is quite effective for nerve regeneration, but even this does not always achieve the desired result. You can additionally stimulate recovery processes with the help of targeted physiotherapy.

Physiotherapy for optic atrophy

There are two physiotherapeutic techniques, whose positive effects are confirmed by scientific research:

Pulsed magnetic therapy (MPT) - this method is not aimed at restoring cells, but at improving their functioning. Thanks to the directed influence of magnetic fields, the contents of neurons are “condensed”, which is why the generation and transmission of impulses to the brain is faster;
Bioresonance therapy (BT) - its mechanism of action is associated with improving metabolic processes in damaged tissues and normalizing 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:

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, some of the vessels on the face are ligated, which is why most of the blood is forced to flow through the ophthalmic artery. This type of intervention is performed quite rarely, as it can lead to complications in the postoperative period;
Transplantation of revascularizing tissues - the principle of this operation is to transplant tissues with an abundant blood supply (parts of muscle, conjunctiva) into an atrophic area. New blood vessels will grow through the graft, ensuring adequate blood flow to the neurons. Such an intervention is much more widespread, since it practically does not affect other tissues of the body.

Several years ago, stem cell treatment methods were actively developed in the Russian Federation. However, an amendment to the country's legislation made these studies and the use of their results on people 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 damage to the nerve trunk and the time of treatment. If the pathological process has affected only a part of the neurocytes, in some cases it is possible to almost completely restore the functions of the eye, with adequate therapy.

Unfortunately, with the atrophy of all nerve cells and the cessation of impulse transmission, there is a high probability of the patient developing blindness. The solution in this case may be surgical restoration of tissue nutrition, but such treatment is not a guarantee of restoration of vision.

Frequently asked questions

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 detected before the age of one year (6-8 months). It is important to consult an ophthalmologist in a timely manner, since the greatest effect of 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 pathology develop in children?

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

Question:
What treatment with folk remedies is most effective?

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

Question:
Do they provide disability groups for atrophy?

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

All therapy is accepted by the patient for life. Short-term treatment is not enough to control this disease.