Update: December 2018
The quality of life is primarily affected by the state of our health. Free breathing, clear hearing, freedom of movement - all this is very important for a person. Violation of the work of even one organ can lead to a change in the usual way of life in a negative direction. For example, the forced rejection of active physical activity (jogging in the morning, visits to the gym), eating tasty (and fatty) dishes, intimate relationships, etc. This is most clearly manifested when the organ of vision is damaged.
Most eye diseases are quite favorable for humans, since modern medicine is able to cure them or reduce their negative effect (to 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 violated significantly and irreversibly. Often patients lose the ability to perform even everyday activities and get disability.
Can this be prevented? Yes you can. But only with the timely detection of the cause of the disease and the adequate treatment.
What is optic atrophy
This is a condition in which the nervous tissue experiences an acute shortage of nutrients, due to which it ceases to fulfill its functions. If the process lasts long enough, neurons begin to gradually die. Over time, it affects an increasing number of cells, and in severe cases, the entire nerve trunk. To restore the function of the eye in such patients will be almost impossible.
In order to understand how this disease manifests itself, it is necessary to imagine the course of impulses to the brain structures. They are conditionally divided into two portions - lateral and medial. In the first one there is a “picture” of the surrounding world, which the inner side of the eye sees (closer to the nose). The second is responsible for the perception of the outer part of the image (closer to the crown of the head).
Both parts are formed on the back wall of the eye, from a group of special (ganglionic) cells, after which they are sent to various brain structures. This path is quite difficult, but there is only one crucial point - almost immediately after leaving the orbit, there is a cross in internal portions. What does this lead to?
- The left tract perceives the image of the world from the left half of the eyes;
- The right one transfers the “picture” from the right halves to the brain.
Therefore, damage to one of the nerves after he left the orbit will lead to a change in the function of both eyes.
Causes
In the vast majority of cases, this pathology does not occur on its own, but is a consequence of another eye disease. It is very important to consider the cause of atrophy of the optic nerve, or rather the place of its occurrence. It is from this factor that the nature of the symptoms of the patient and the characteristics of therapy will depend.
There may be two options:
- Rising type - the disease occurs from the part of the nerve trunk that is closer to the eye (before the intersection);
- A descending form - the nervous tissue begins to atrophy from top to bottom (above the intersection, but before entering the brain).
The most common causes of these conditions are presented in the table below.
| Characteristic causes | a brief description of |
Ascending type |
|
| Glaucoma | Under this word lies a number of violations 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 nervous tissue and makes them atrophic. |
| Intrabulbar neuritis | Infectious process that affects neurons in the cavity of the eyeball (intrabulbar form) or behind it (retrobulbar type). |
| Retrobulbar neuritis | |
| Toxic nerve lesions | The effect of toxic substances on the body leads to the breakdown of nerve cells. The following actions have a damaging effect on the analyzer:
|
| Ischemic disorders | Ischemia is a lack of blood flow. May occur with:
|
| Stagnant disk | By nature, this is edema of the initial part of the nerve trunk. It can occur in any condition associated with an increase in intracranial pressure:
|
| Tumors of the nerve or surrounding tissues, located before the intersection | Pathological proliferation of tissues can lead to compression of neurons. |
Descending type |
|
| Toxic lesions (less commonly) | In some cases, the toxic substances described above can damage neurocytes after crossing. |
| Tumors of the nerve or surrounding tissues located after the intersection | Oncological processes are the most frequent and most dangerous cause of the downward form of the disease. They are not divided into benign, since the complexity of the treatment allows us to call all brain tumors malignant. |
| Specific lesions of the nerve tissue | In the outcome of some chronic infections that occur with the destruction of neurocytes throughout the body, the trunk of the optic nerve may partially / atrophy. These specific lesions include:
|
| Abscesses in the cranial cavity | After neuroinfections (meningitis, encephalitis and others), cavities limited by connective tissue walls - abscesses can occur. 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 its clarification. Symptoms of the disease can help diagnose, which distinguish the ascending form from the descending form.
Symptoms
Regardless of the level of damage (above the intersection or below), there are two reliable signs of optic atrophy - a loss of visual fields ("anopsy) and a decrease in visual acuity (amblyopia). How they will be expressed in a particular patient depends on the severity of the process and the activity of the cause of the disease. Consider these symptoms in more detail.
Loss of visual fields (anopsia)
What does the term "field of view" mean? In fact, this is just a zone that a person sees. To imagine it, you can close half of your eye on either side. At the same time, you see only half of the picture, since the analyzer cannot perceive the second part. We can say that you have “dropped out” one (right or left) zone. This is exactly what anopsia is - the disappearance of the field of vision.
Neurologists divide it into:
- temporal (half of the image 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 out.
With partial atrophy of the optic nerve, there may not be any symptoms, since the remaining neurons transmit information from the eye to the brain. However, if a lesion occurs across the entire thickness of the trunk, this symptom will certainly appear in the patient.
What zones will fall out of the patient’s perception? It depends on the level at which the pathological process is located and on the degree of cell damage. There are several options:
| Type of atrophy | Lesion level | What does the patient feel? |
| Full - the entire diameter of the nerve trunk is damaged (the signal is interrupted and not transmitted to the brain) | The organ of vision from the affected side completely ceases to see | |
| Right or left visual fields in both eyes fall out | ||
| Incomplete - only part of the neurocytes do not fulfill their function. Most of the image is perceived by the patient. | Before the cross (in ascending form) | Symptoms may be absent or the field of vision in one of the eyes falls out. Which one - depends on the location of the atrophy of the process. |
| After the crosshair (with the descending type) |
This neurological symptom seems difficult to perceive, but thanks to it, an experienced specialist can identify the site of the lesion without any additional methods. Therefore, it is very important that the patient openly tells his doctor about any signs of loss of visual fields.
Decreased visual acuity (amblyopia)
This is the second sign that is observed in all patients without exception. Only the degree of its severity varies:
- Light - characteristic of the initial manifestations of the process. The patient does not feel a decrease in vision, a symptom manifests itself only with careful examination of distant objects;
- Medium - occurs when a significant part of neurons is affected. Remote objects are practically invisible, at a short distance the patient does not have difficulty;
- Severe - indicates the activity of the pathology. The severity is reduced so much that even objects located nearby become difficult to distinguish;
- Blindness (synonymous with amovrosis) is a sign of complete atrophy of the optic nerve.
As a rule, amblyopia occurs suddenly and gradually increases, without adequate treatment. If the pathological process proceeds aggressively or the patient did not seek help in a timely manner, there is a likelihood of irreversible blindness.
Diagnostics
As a rule, problems with the detection of this pathology are rare. The main thing is that the patient promptly seek medical help. To confirm the diagnosis, he is referred to an ophthalmologist for examination of the fundus. This is a special technique with which you can examine the initial section of the nerve trunk.
How is ophthalmoscopy performed?. In the classic version, the eye fundus is examined by a doctor in a dark room, using a special specular device (ophthalmoscope) and a light source. Using modern equipment (electronic ophthalmoscope) allows us to conduct this study with greater accuracy. The patient does not need any preparation for the procedure or special actions during the examination.
Unfortunately, ophthalmoscopy does not always detect changes, since the symptoms of the lesion occur earlier than tissue changes. Laboratory tests (blood, urine, cerebrospinal fluid tests) are non-specific and have only auxiliary diagnostic value.
How to act in this case? In modern multidisciplinary hospitals, to detect the cause of the disease and changes in the nervous tissue, the following methods exist:
| Research Method | Method principle | Atrophy changes |
| Fluorescence Angiography (FAG) | The patient is injected with a dye through a vein, which enters the vessels of the eyes. Using a special device that emits light of various frequencies, the fundus is "highlighted" and its condition is evaluated. | Signs of circulatory failure and tissue damage |
| Laser disc imaging (HRTIII) | Non-invasive (remote) method for studying fundus anatomy. | Change in the initial section of the nerve trunk by type of atrophy. |
| Optical coherence tomography (OCT) of the optic disc | Using high-precision infrared radiation to assess the condition of the tissues. | |
| CT / MRI of the brain | Non-invasive methods for studying the tissues of our body. Allow you to get an image at any level, accurate to see. | Used to find out the possible cause of the disease. Typically, the goal of this study is to search for a tumor or other volumetric mass (abscesses, cysts, etc.). |
Therapy of the disease begins from the moment the patient contacts, since waiting for the results of the diagnosis is irrational. During this time, the pathology can continue to progress, and changes in the tissues will become irreversible. After clarifying the reasons, the doctor adjusts his tactics to achieve the optimal effect.
Treatment
It is widely believed in society that "nerve cells are not restored." This is not entirely correct. Neurocytes can grow, increase the number of connections with other tissues and take on the functions of the dead "comrades." However, they do not have one property that is very important for complete regeneration - the ability to reproduce.
Can optic atrophy be cured? Definitely not. With partial damage to the trunk, medications can improve visual acuity and field of view. In rare cases, it is even possible to practically restore the patient's ability to see to a normal level. If the pathological process completely disrupted the transmission of impulses from the eye to the brain, only surgery can help.
For successful treatment of this disease, it is necessary, first of all, to eliminate the cause of its occurrence. This will prevent / reduce cell damage and stabilize the pathology. Since there are a large number of factors that cause atrophy, the tactics of doctors can vary significantly in different conditions. If it is not possible to cure the cause (a malignant tumor, an inaccessible abscess, etc.), you should immediately begin to restore the efficiency of the eye.
Modern methods of nerve repair
10-15 years ago, the main role in the treatment of optic atrophy was assigned to vitamins and angioprotectors. Currently, they have only additional value. Drugs that restore the metabolism in neurons (antihypoxants) and increase blood flow to them (nootropics, antiplatelet agents and others) come to the fore.
The modern scheme for restoring the functions of the eye includes:
- Antioxidant and antihypoxant (Mexidol, Trimetazidine, Trimectal and others) - this group is aimed at restoring tissues, reducing the activity of damaging processes, eliminating "oxygen starvation" of the nerve. In a hospital setting, they are administered intravenously, with outpatient treatment, antioxidants are taken in tablet form;
- 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 stimulants of the blood flow of 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 introduced parabulbarno (a thin needle is passed along the wall of the orbit into the fiber surrounding the eye);
- Vitamins C, PP, B 6, B 12 are an additional component of therapy. It is believed that these substances improve metabolism in neurons.
The classical treatment for atrophy is given above, however, in 2010, ophthalmologists proposed fundamentally new methods for restoring the eye, using peptide bioregulators. Currently, only two drugs are widely used in specialized centers - Cortexin and Retinalamin. In the course of research, it was proved that they improve the state of vision almost twice.
Their effect is realized through two mechanisms - these bioregulators stimulate the restoration of neurocytes and limit the damaging processes. The method of their application is quite specific:
- Cortexin - used as an injection into the skin of the temples or intramuscularly. The first method is preferred, since it creates a higher concentration of the substance;
- Retinalamin - the medicine is injected into parabulbar fiber.
The combination of classical and peptide therapy is quite effective for nerve regeneration, but even it does not always allow to achieve the desired result. Additionally, recovery processes can be stimulated using targeted physiotherapy.
Physiotherapy for optic atrophy
There are two physiotherapeutic methods, whose positive effect is confirmed by research by scientists:
- Pulse magnetotherapy (UTI) - this method is not aimed at restoring cells, but at improving their performance. Due to the directed influence of magnetic fields, the content of neurons “thickens”, due to which the generation and transmission of impulses to the brain is faster;
- Bioresonance therapy (BT) - its mechanism of action is associated with improved metabolic processes in damaged tissues and normalization of blood flow through microscopic vessels (capillaries).
They are very specific and are used only in large regional or private ophthalmological centers, due to the need for expensive equipment. As a rule, for most patients, these technologies are paid, so BMI and BT are rarely used.
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, part of the vessels on the face is bandaged, which is why most of the blood is forced to go through the ophthalmic artery. This type of intervention is rarely performed, as it can lead to complications in the postoperative period;
- Transplantation of revascularizing tissues - the principle of this operation is the transplantation of tissues with abundant blood supply (parts of the muscle, conjunctiva) to the atrophic region. New vessels will sprout through the graft, which will ensure an adequate blood flow to the neurons. Such an intervention is much more widespread, since other tissues of the body do not practically suffer from it.
Several years ago, in the Russian Federation, stem cell treatment methods were actively developed. However, the amendment to the legislation of the country made these studies and the application of their results to 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 initiation. If the pathological process has affected only part of the neurocytes, in some cases, it is possible to almost completely restore the function of the eye, against the background of adequate therapy.
Unfortunately, with atrophy of all nerve cells and the cessation of impulse transmission, the patient is more likely to develop blindness. The solution in this case may be surgical restoration of tissue nutrition, but such treatment is not a guarantee of restoration of vision.
FAQ
Question:
Could this disease be congenital?
Yes, but very rarely. In this case, all the symptoms of the disease described above are manifested. As a rule, the first signs are detected before the age of one year (6-8 months). It is important to contact 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 atrophy be cured?
It should be emphasized once again - 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 function, but it is impossible to cure it.
Question:
How often does pathology develop in children?
No, these are quite rare cases. If the child has a diagnosed and confirmed diagnosis, it is necessary to clarify whether it is congenital.
Question:
What is the most effective treatment for folk remedies?
Atrophy is difficult to treat even with highly active drugs and specialized physiotherapy. Folk techniques will not have a significant impact on this process.
Question:
Do disabilities give atrophy?
It depends on the degree of vision loss. Blindness is an indication for the appointment of the first group, severity from 0.3 to 0.1 - for the second.
All therapy is taken by the patient for life. In order to control this disease, short-term treatment is not enough.
1178 10/10/2019 6 min.Among the most common ophthalmic diseases is partial atrophy of the optic nerve (ChASN). This disease poses a serious danger, because from a partial one in case of incorrect treatment or absence of one, it can turn into a complete one - when a person becomes completely blind.
Description of partial optic atrophy (CASN) and ICD-10 code
Atrophy in ophthalmology is the death of tissues, fibers of the optic nerve. Atrophied tissue is replaced by a simple connective tissue, which is not able to transmit signals from nerve cells to the organs of vision. As a result of the disease, the ability to see is sharply reduced, and if treatment is not started on time, partial atrophy can turn into complete atrophy, which will lead to absolute loss of vision. The ICD disease code is H47.2.
In the case of partial atrophy of the optic nerve head (optic nerve disc), a person can see, however, the colors are not transmitted correctly, the contours of objects are distorted, there is a blur in front of the eyes, blurry, and other visual defects occur.
structure of the eyeball
Vision in this case can decrease both extremely sharply (in a few days) and quite gradually (and over several months). Usually, having decreased, vision in this case stabilizes - it is this fact that gives reason to talk about partial atrophy. If vision, having decreased, no longer falls, a complete partial atrophy of the optic nerve is diagnosed. However, the disease can be progressive - in this case, it just leads to complete blindness (if not treated).
Previously, partial atrophy of the optic nerve, not to mention the complete one, was the basis for prescribing disability. Modern medicine, fortunately, makes it possible to cure pathology, especially if it is detected in the very early stages.
Reasons for Dying of DZN
The main causes of partial optic atrophy are the most common ocular pathologies:
- myopia (including age);
- glaucoma;
- retinal lesions;
- defects in optic fibers;
- tumor-like formations of any etiology in the organs of vision;
- inflammatory processes.
stage of atrophy of the optic nerve
In addition to the above, sometimes (less often) the causes of the disease are the following pathologies:
- syphilis;
- encephalitis;
- meningitis;
- purulent brain abscess.
optic nerve location scheme
The appearance of cattle (blind spots) is also a common symptom in this disease. In this case, the person sees the picture partially, some areas drop out of the general overview, in their place - whitish cloudy spots.
Why prescribe drops of bestoxol can be read.
Diagnostics
As a rule, this disease is diagnosed without any difficulties. It is impossible not to notice a sharp decrease in vision, so the vast majority of patients themselves turn to the ophthalmologist, who already makes the diagnosis. An examination of the organs of vision of a sick person will necessarily in this case show deformation of the optic nerve, its color is paler than necessary.
In children
Partial atrophy of the optic nerve is a disease typical of adults, in children it is rare. However, in recent years, ophthalmologists have noticed a rejuvenation of the disease, so the occurrence of pathology in adolescents and children is no longer surprising. Sometimes the disease occurs even in newborns.
The causes of the disease of children are as follows:
- severe heredity (leads to congenital ChASN);
- pathologies of the retina, nerve - dystrophy, trauma, edema, congestion, inflammatory processes;
- pathologies of a neurological nature - meningitis, encephalitis, head injuries, purulent abscesses of the meninges, tumor-like formations;
partial atrophy
In addition to the above, this disease in children can develop as a result of prolonged vitamin deficiency, high blood pressure, excessive mental and physical stress with insufficient nutrition.
The causes of optic neuritis can be found.
Treatment and prognosis
Usually, with a timely visit to a doctor, the prognosis for this disease is favorable. The goal of therapy is to stop the deformation of the tissues of the optic nerve, maintaining the level of vision that is still available. It is impossible to restore full vision in this case, since already deformed tissues of the optic nerve cannot be restored.
The method of therapy is selected depending on the underlying cause of the disease. Typically, the following types of medications are used in the treatment of partial atrophy of the optic nerve:
- improving cerebral blood flow;
- activating metabolic processes, metabolism;
- dilating blood vessels;
- multivitamins;
- stimulants of biological processes.
Also, during treatment, agents that activate regenerative processes in the tissues of the organs of vision, which improve metabolic processes, are necessarily used. It:
- stimulants - aloe extracts, peat;
- glutamic acid as an amino acid;
- ginseng extracts, eleutherococcus as vitamin supplements and immunostimulants.
Drugs are also prescribed that help to quickly resolve pathological processes that stimulate metabolism:
- Pyrogenal;
- Phosphaden;
- Preducted.
It is unacceptable to use any medications prescribed on their own - all medications must be taken strictly for medical purposes and the scheme proposed by a specialist.
No folk remedies and alternative medicine in this case can not help health. Therefore, do not waste precious time, but you should immediately consult a doctor for expert help.
How to treat through surgery and physiotherapy
If the disease requires surgical intervention, then the operation will be the main method in this case. And if vision has fallen quite badly, there is reason to designate a disability group.
pathways of the optic nerve
The emphasis in therapy is on eliminating the underlying disease, which was the direct cause of atrophy. In order for the treatment result to be achieved faster and more efficiently, additional procedures are prescribed:
- ultrasound;
- magnetic resonance procedure;
- electrophoresis;
- laser;
- oxygen therapy.
In this case, it is important to start treatment as early as possible. The sooner therapy begins, the greater part of the optic nerve can be saved. Moreover, atrophied fibers cannot be restored, so the part of the nerve that is affected will not recover.
How to treat a lazy eye in adults can be read.
Prevention
In order to cope with this disease as soon as possible, it is important to seek medical help in a timely manner. In addition, abstinence from the use of alcohol and drugs will help prevent the occurrence of pathology. The fact is that alcohol and drug intoxication are one of the factors that provoke atrophy.
Video
What is atrophy and signs of the disease we learn from the video.
Output
Partial atrophy of the optic nerve is a serious pathology, and if you do not pay attention to it in time, it can lead to complete blindness. Therefore, be sure to visit an ophthalmologist if vision begins to sharply and unreasonably decline - the sooner you start treatment, the greater part of the optic nerve will be saved.
Partial atrophy of the optic nerve is a simpler form of atrophy, in which the fibers responsible for the accuracy of image transmission to the brain are affected. As a rule, the fibers begin to die, after which they are replaced by connective tissue. And it, in turn, cannot replace the functions of the fibers, and therefore there is a decrease in vision and field. There are only 2 forms of atrophy on the optic nerve. It is partial and complete.
By full is meant the death of the fibers completely, which inevitably causes blindness. Unlike the full form, only a small part of the fibers dies in partial, but this is also fraught with complications. Therefore, it is extremely important to timely detect atrophy and conduct treatment. It is worth noting that the partial is manifested by a slight weakening of sharpness and a significant loss of the ability to see color shades.
Initially, you need to understand how image information is transmitted to the visual part of the brain. It turns out that when the image is perceived, a light signal appears that passes through the retina and enters the brain through the optic nerve. It would seem that everything is simple, but the nerve has an excessively huge number of fibers and each of them is responsible for a certain area. If there is a problem of dying, then this light signal comes already in an altered pathological form, as a result of which vision is impaired.
what causes the disease
Partial atrophy of the optic nerve causes:
- Compression of the optic nerve by various growths or tumors.
- Pathology of the retina.
- Glaucoma.
- Inflammation in the nerve.
- Myopia.
- Pathology of the brain.
- Infectious manifestations: encephalitis, brain abscess, meningitis, arachnoiditis.
- Sclerosis.
- Atherosclerosis.
- Hypertension.
- Heredity.
- Poisoning by chemicals, alcohol.
- Pathologies of the nervous system, heart and blood vessels.
- Injury
Signs of a partial form of the disease
You need to know that usually with this disease two organs are affected simultaneously, but with a different degree (initially). The severity of the disease in total is 4. as a rule, the weaker the degree, the less signs are expressed. With the course of the disease, the symptoms intensify and aggravate. So, partial atrophy of the optic nerves in both eyes symptoms:
- Decreased visual acuity.
- When the eye moves, the patient experiences pain.
- The disappearance of lateral vision due to the narrowing of the field of view. And subsequently it can even fall out.
- The appearance in the eyes of dark spots, which are characterized as blind.
Partial nerve atrophy treatment
In contrast to the full form, partial optic atrophy is still treatable. It is aimed at stopping pathological changes in tissues directly in the optic nerve. In this case, the preservation of what remains in a healthy functional form is a necessity. Those fibers that have already turned into connective tissue are almost impossible to restore, but without treatment it is impossible. Otherwise, the pathology will progress, and this will lead to complete blindness.
As a rule, initially conservative treatment is used. Preparations are selected that improve the blood supply to the nerve of the visual apparatus, accelerate metabolic processes throughout the body at the cellular level, dilate blood vessels, biostimulating drugs and multivitamin. Thanks to such medications, nutrition and saturation of the optic organs with useful substances are performed, nerve swelling is reduced, the inflammatory process is eliminated, which leads to the stimulation of healthy fibers.
In more complex cases, or if drug therapy did not give a positive result, the surgical method of treatment is used. Here, the cause of the disease is eliminated in the first place, in order to avoid further development. In combination with the two methods listed above, physiotherapy is recommended. This can be laser correction, electrical stimulation, exposure to the affected organ with magnetic rays, electrophoresis, and even oxygen therapy.
Treatment according to cause
Therapy always depends on the cause of the pathology. For example:
- With partial atrophy of the optic nerve, acquired due to disruption of the vascular system, vasoactive drugs and antioxidant drugs are used. It can be “Sermion”, “Cavinton” and “Tanakan”, as well as “Mexidop”, “Mildronate” and “Emoksipin”.
- If the disease appeared due to disorders of the nervous system, then nootropic and fermentotropic drugs are used. For example, Actovegin, Nootropil, Sopkoseril, Wobenzym, and Phpogenzim.
- With toxic partial atrophy, not only vasoactive, nootropic drugs are used, but also detoxification and peptide drugs.
- With downward atrophy of a partial form, bioregulatory therapy is indicated with the use of drugs such as Cortexin and Epithalamin.
- If the disease arose against the background of genetic heredity, trauma or inflammation, then cytomedines (“Cortexin” or “Retinals”) are used.
Partial atrophy of the optic nerve: disability is assumed in the same way as in the case of complete atrophy. But in this case, group 3 is used if there is a 2 degree of severity of the disease. At the same time, there should be a weakened visualization of medium objects. For other groups of disability should be indicators characteristic of complete atrophy.
How to treat children
With partial atrophy of the optic nerve in children, treatment is prescribed almost identical to adults. The same goal is the inhibition of the progression and death of fibers. They feed the nerve without fail, saturate it with oxygen. Drugs can be administered both drip and by injection. Electrophoresis, oxygen therapy and ultrasound procedures are always used.
2708 08/02/2019 6 min.Any sensations in the human body, both external and internal, are possible only due to the functioning of nerve tissue, the fibers of which are found in almost every organ. Eyes are not an exception in this regard, therefore, when destructive processes in the optic nerve begin, a person is threatened with partial or complete loss of vision.
Disease definition
Atrophy of the optic nerve (or optical neuropathy) is a process of death of nerve fibers, which proceeds gradually and is most often the result of malnutrition of the nervous tissue due to poor blood supply.
Image transmission from the retina to the visual analyzer in the brain occurs through a kind of “cable” consisting of many nerve fibers and packaged in “isolation”. The thickness of the optic nerve is not more than 2 mm, however, it contains more than a million fibers. Each part of the image corresponds to a certain part of them, and when some of them cease to function, “silent zones” appear in the image perceived by the eye (image disturbance).
When cells of nerve fibers die, they are gradually replaced by connective tissue or auxiliary nervous tissue (glia), which is normally designed to protect neurons.
Kinds
Depending on the causative factors, two types of optic atrophy are distinguished:
- Primary The disease is caused by the affected X-chromosome, therefore only men aged 15-25 suffer from it. Pathology develops according to the recessive type and is inherited;
- Secondary It arises as a result of an eye or systemic disease associated with a violation of the blood supply or stagnation of the optic nerve. Such a pathological condition can occur at any age.
Classification is also carried out according to the location of the lesion:
The following types of atrophy are also distinguished: initial, complete and incomplete; unilateral and bilateral; stationary and progressive; congenital and acquired.
Causes of occurrence
The frequency of various pathological processes in the optic nerve is only 1-1.5%, and in 19-26% of them the disease ends in complete atrophy and incurable blindness.
The cause of the development of optic atrophy can be any disease that results in edema, compression, inflammation, damage to nerve fibers or damage to the vascular system of the eyes:
- Ocular pathologies: retinal pigment dystrophy, etc.
- Glaucoma and increased IOP;
- Systemic diseases: hypertension, atherosclerosis, spasms of blood vessels;
- Toxic effects: smoking, alcohol, quinine, drugs;
- Brain diseases: abscess, multiple sclerosis, arachnoiditis;
- Traumatic injuries;
- Infectious diseases: meningitis, encephalitis, syphilitic lesion, tuberculosis, flu, measles, etc.
Is it possible to cure glaucoma?
Whatever the reason for the onset of atrophy of the optic nerve, nerve fibers die irrevocably, and the main thing is to quickly diagnose in order to slow down the process in time.
Symptoms
The main sign of the onset of pathology can serve as a steadily progressive deterioration in vision in one or both eyes, and it does not lend itself to conventional methods of correction.
Visual functions are gradually lost:
The manifestation of symptoms may proceed depending on the severity of the lesions for several days or months, but without a timely response invariably leads to complete blindness.
Possible complications
The diagnosis of optic atrophy should be made as early as possible, otherwise loss of vision (partial or complete) is inevitable. Sometimes the disease affects only one eye - in this case, the consequences are not so severe.
Rational and timely treatment of the disease, which caused atrophy, allows in some cases (not always) to maintain vision. If the diagnosis is made at the stage of an already developed disease, the prognosis is most often unfavorable. 
If the disease began to develop in patients with indicators of vision below 0.01, then therapeutic measures are likely to give no result.
Diagnostics
A targeted ophthalmic examination is the first mandatory step in case of suspected illness. In addition, consultation with a neurosurgeon or neurologist may be required.
To detect atrophy of the optic nerve, the following types of examinations can be performed:
- Fundus examination (or biomicroscopy);
- - determination of the degree of visual impairment (myopia, hyperopia, astigmatism);
- - study of visual fields;
- Computer perimetry - allows you to identify the affected area of \u200b\u200bthe nervous tissue;
- Assessment of color perception - determination of the localization of lesions of nerve fibers;
- Video phthalmography - revealing the nature of damage;
- Craniography (X-ray of the skull) - the main object in this case is the region of the Turkish saddle.
Read more about aK is undergoing fundus examination by .
To clarify the diagnosis and additional data, it is possible to conduct studies: CT, magnetic resonance, laser dopplerography.
Treatment
With partial damage to nerve fibers, treatment must be started quickly and intensively. First of all, the efforts of doctors are aimed at eliminating the causes of the pathological condition in order to stop the progression of the disease.
Drug therapy
Since the restoration of dead nerve fibers is impossible, therapeutic measures are carried out to stop the pathological process by all known means:
- Vasodilators: Niacin, No-spa, Dibazole, Eufillin, Complamin, Papaverine, etc. The use of these drugs helps to stimulate blood circulation;
- Anticoagulants: Heparin, Tiklid. Drugs prevent thickening of the blood and the formation of blood clots;
- Biogenic stimulants: Vitreous humor, Aloe extract, Peat. Enhance metabolism in nerve tissues;
Heparin ointment is used in the treatment of optic nerve arthophy
- Vitamins: Ascorutin, B1, B6, B2. They are the catalysts for most biochemical reactions that occur in the tissues of the eyes, just like amino acids and enzymes;
- Immunostimulants: Ginseng, Eleutherococcus. Necessary to stimulate the processes of regeneration and suppression of inflammation in infectious lesions;
- Hormonal drugs: Dexamethasone, Prednisone. Used in the absence of contraindications to relieve symptoms of inflammation;
- Improving the central nervous system:, Nootropil, Cavinton, Cerebrolysin, Fezam.
Instruction D examethasone for the eyes is located.
Dexamethasone is used in the treatment of optic nerve arthophy
In each case, treatment is prescribed individually under the supervision of the attending physician.
In the absence of contraindications, an additional effect can be achieved using acupuncture, as well as methods of physiotherapeutic treatment:
- Ultrasound;
- Electrophoresis;
- Optical and laser stimulation of the optic nerve;
- Magnetotherapy.
Such procedures can have a positive effect in case of incomplete loss of functionality by nerve cells.
Surgically
Surgical methods are resorted to under the threat of complete blindness, as well as in other situations requiring surgical intervention. The following types of operations can be used for this:
Various surgical treatment techniques have been successfully practiced in clinics in Russia, Israel and Germany.
Folk remedies
Treatment of atrophy of the optic nerve should be carried out with medications under the guidance of a qualified doctor. However, often such therapy takes a long time, and in this case, folk remedies can provide invaluable help - after all, the effect of most of them is aimed at stimulating metabolism and increasing blood circulation:
- Dissolve 0.2 g of mummy in a glass of water, drink on an empty stomach before dinner, and also in the evening with a glass of the product for 3 weeks (20 days);
- Make an infusion of crushed astragalus grass (2 tbsp. Dried raw materials per 300 ml of water), insist 4 hours. Within 2 months take 100 ml of infusion 3 r. in a day;
- Peppermint is called eye grass, it is useful to eat it, and bury the eyes with juice mixed with equal amounts of honey and water in the morning and evening;
- You can eliminate eye fatigue after prolonged work on a computer using lotions from infusions of dill, chamomile, parsley, blue cornflower and ordinary tea leaves;
- Grind immature pine cones and cook 1 kg of raw material for 0.5 hours. After filtering add 1 tbsp. honey, stir and refrigerate. Consume 1 p. per day - in the morning before meals 1 tsp. ;
- Pour 1 tbsp. l parsley leaves 200 ml of boiling water, let it brew in a dark place for 24 hours, after which take 1 tbsp. l in a day.
Folk remedies should be used in treatment only after consulting an ophthalmologist, since most plant components have an allergenic effect and can have an unexpected effect in the presence of some systemic pathologies.
Prevention
In order to avoid atrophy of the optic nerve, it is worth paying attention to preventive measures not only for ocular, but also for systemic diseases:
- Timely treat eye and systemic infectious diseases;
- Prevent ocular and head injuries;
- Do preventive examinations in an oncology clinic;
- Limit or exclude alcohol from your life;
- Take control of blood pressure.
Color blindness test online can be found.
Video
conclusions
Atrophy of the optic nerve is an almost incurable disease in the late stages that threatens the patient with complete blindness. However, partial atrophy can be suspended, and the main direction before the development of medical tactics should be an extensive diagnosis - after all, it will help to establish the cause of the changes and try to stop them.
Therefore, try to pay increased attention not only to eye health, but also to the entire body. After all, everything is interconnected in it, and vascular or nerve diseases can affect the quality of vision.
Also read about red spots under the eyes.
Atrophy of the optic nerve (optical neuropathy) - partial or complete destruction of nerve fibers that transmit visual irritation from the retina to the brain. During atrophy, the nervous tissue experiences an acute shortage of nutrients, due to which it ceases to fulfill its functions. If the process lasts long enough, neurons begin to gradually die. Over time, it affects an increasing number of cells, and in severe cases, the entire nerve trunk. To restore the function of the eye in such patients will be almost impossible.
What is the optic nerve?
The optic nerve belongs to the cranial peripheral nerves, but in essence it is not a peripheral nerve either in origin, in structure, or in function. This is the white matter of the brain, pathways that connect and transmit visual sensations from the retina to the cerebral cortex.
The optic nerve delivers nerve messages to the area of \u200b\u200bthe brain responsible for the processing and perception of light information. It is the most important part of the whole 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 in this area can have serious complications and consequences.
ICD optic atrophy has an ICD code of 10
Causes
The development of atrophy of the optic nerve is caused by various pathological processes in the optic nerve and retina (inflammation, dystrophy, edema, circulatory disorders, the action of 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 after a short period of time after the birth of the baby.
- Acquired atrophy is a consequence of adult diseases.
Factors leading to optic atrophy can be eye diseases, central nervous system lesions, mechanical damage, intoxication, general, infectious, autoimmune diseases, etc. Atrophy of the optic nerve occurs as a result of obstruction of the central and peripheral arteries of the retina that feed the optic nerve, as well as is the main sign 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, retinal pigment dystrophy)
- Intoxication (quinine, nicotine and other drugs)
- Alcohol poisoning (more precisely, alcohol substitutes)
- Viral infections (, flu)
- Pathology of the central nervous system (brain abscess, syphilitic lesion, skull trauma, multiple sclerosis, tumor, syphilitic lesion, skull trauma, encephalitis)
- Atherosclerosis
- Hypertonic disease
- Profuse bleeding
The cause of primary downward atrophy is vascular disorders in:
- hypertension
- atherosclerosis;
- pathology of the spine.
Secondary atrophy is caused by:
- acute poisoning (including alcohol substitutes, nicotine and quinine);
- retinal inflammation;
- malignant neoplasms;
- traumatic injury.
Atrophy of the optic nerve can provoke inflammation or dystrophy of the optic nerve, its compression or trauma, leading to damage to nerve tissue.
Types of disease
Atrophy of the optic nerve of the eye is:
- Primary atrophy (ascending and descending), as a rule, develops as an independent disease. The descending atrophy of the optic nerve is most often diagnosed. This type of atrophy is a consequence of the fact that the nerve fibers themselves are affected. It is transmitted by recessive type by inheritance. This disease is linked exclusively to the X chromosome, which is why only men suffer from this pathology. It manifests itself in 15-25 years.
- Secondary atrophy usually develops after the occurrence of a 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 atrophy also includes such variants of this pathology:
Partial optic atrophy
A characteristic feature of the partial form of optic atrophy (or initial atrophy, as it is also determined) is the incomplete preservation of the visual function (proper vision), which is important for reduced visual acuity (because of the use of lenses or glasses does not allow to improve the quality of vision). Residual vision, although it is subject to conservation in this case, however, there are violations in terms of color perception. Preserved areas in the field of view remain accessible.
Complete atrophy
Any self-diagnosis is excluded - only specialists can make an accurate diagnosis if they have the proper equipment. This is also due to the fact that the symptoms of atrophy have much in common with amblyopia and cataracts.
In addition, atrophy of the optic nerve can occur in a stationary form (that is, in a finished form or in a non-progressive form), which indicates a stable state of relevant 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 atrophy is the reduction in visual acuity with the help of glasses and lenses.
- With progressive atrophy, a decrease in visual function develops from a few 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, in connection with which vision is partially lost.
With partial atrophy, the process of visual impairment stops at some stage, and vision stabilizes. Thus, progressive and complete atrophy can be distinguished.
Alarming symptoms that may indicate that optic atrophy develops are:
- narrowing and disappearance of the fields of view (lateral vision);
- the appearance of "tunnel" vision associated with a violation of color sensitivity;
- occurrence by cattle;
- manifestation of an afferent pupillary effect.
The manifestation of symptoms can be unilateral (in one eye) and multilateral (in both eyes at the same time).
Complications
The diagnosis of optic atrophy is very serious. At the slightest decrease in vision, you must immediately consult a doctor so as not to miss your chance for recovery. In the absence of treatment and with the progression of the disease, vision may disappear completely, and it will be impossible to restore it.
In order to prevent the occurrence of pathologies of the optic nerve, it is necessary to carefully monitor your health, undergo regular examination with specialists (rheumatologist, endocrinologist, neurologist, optometrist). At the first signs of visual impairment, you should seek the advice of an ophthalmologist.
Diagnostics
Atrophy of the optic nerve is a rather serious disease. In case of even the slightest decrease in vision, it is necessary to visit an ophthalmologist so as not to miss the precious time for the treatment of the disease. Any self-diagnosis is excluded - only specialists can make an accurate diagnosis if they have the proper equipment. This is also due to the fact that the symptoms of atrophy have much in common with amblyopia and.
Examination by an ophthalmologist should include:
- visual acuity test;
- examination through the pupil (expand with special drops) of the entire fundus;
- spheroperimetry (accurate determination of the boundaries of the field of view);
- laser dopplerography;
- assessment of color perception;
- craniography with a snapshot of the Turkish saddle;
- computer perimetry (allows you to identify which part of the nerve was affected);
- video phthalmography (allows you to identify the nature of damage to the optic nerve);
- computed tomography, as well as magnetic nuclear resonance (specify the cause of optic nerve disease).
Also, a certain information content is achieved to compile the overall picture of the disease by conducting laboratory research methods, such as blood tests (general and biochemical), testing for or for syphilis.
Treatment of optic atrophy of the eye
Treatment of optic atrophy is a very difficult task for doctors. You need to know that damaged nerve fibers cannot be restored. One can hope for some effect from the treatment only when restoration of the functioning of nerve fibers that are in the process of destruction, which still retain their vital functions. If this moment is missed, then vision on the sore eye can be lost forever.
In the treatment of optic atrophy, the following actions are performed:
- Biogenic stimulants (vitreous, aloe extract, etc.), amino acids (glutamic acid), immunostimulants (eleutherococcus), vitamins (B1, B2, B6, ascorutin) are prescribed to stimulate the restoration of altered tissue, as well as to improve metabolic processes.
- Vasodilators are prescribed (no-shpa, diabazole, papaverine, sermion, trental, zufillin) - to improve blood circulation in the vessels that feed the nerve
- To maintain the functioning of the central nervous system, phezam, emoxipin, nootropil, cavinton are prescribed
- To accelerate the resorption of pathological processes - pyrogenal, preductal
- Hormonal drugs are prescribed for the relief of the inflammatory process - dexamethasone, prednisone.
Drugs are taken only as prescribed by the doctor and after an accurate diagnosis is 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 assigned an appropriate rehabilitation course. It is aimed at compensating and, if possible, eliminating all those restrictions that arise in life after suffering atrophy of the optic nerve.
Basic physiotherapeutic methods of therapy:
- color stimulation;
- light stimulation;
- electrical stimulation;
- magnetostimulation.
To achieve the best result, magnetic, laser stimulation of the optic nerve, ultrasound, electrophoresis, oxygen therapy can be prescribed.
The earlier treatment is started, the more favorable the prognosis of the disease. Nerve tissue is practically impossible to recover, so the disease cannot be started, it must be treated in a timely manner.
In some cases with atrophy of the optic nerve, surgery and surgery may also be relevant. According to the results of the research, the fibers of the optic are not always dead, some may be in a parabiotic state and may return to life with the help of a professional with extensive experience.
The prognosis of optic atrophy is always serious. In some cases, you can count on the preservation of vision. With developed atrophy, the prognosis is poor. The treatment of patients with optic atrophy, in whom visual acuity was less than 0.01 for several years, is ineffective.
Prevention
Atrophy of the optic nerve is a serious disease. For its prevention, you need to follow some rules:
- Consultation with a specialist at the slightest doubt in the visual acuity of the patient;
- Prevention of various types of intoxication
- timely treatment of infectious diseases;
- do not abuse alcohol;
- monitor blood pressure;
- prevent eye and head injuries;
- repeated blood transfusion with profuse bleeding.
Timely diagnosis and treatment can restore the state of vision in some cases, as well as slow down or stop the progression of atrophy in others.
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