Optic nerve atrophy: causes of pathology and treatment. Optic nerve atrophy (partial and complete) - causes, symptoms, treatment and prevention

Nobody in the world treats atrophy optic nerve.
And we treat.

SYMPTOMS OF THE DISEASE
1. decreased peripheral and central vision
2. the patient constantly sees a “dark spot in front of the eye”, or does not see half of the field of vision.
3. difficulties in reading and other visual work,
4. violation of orientation in space
5. decreased color perception.

HOW WE TREAT
Currently, atrophy (link to what atrophy is) of the optic nerve is treated with vasodilators, vitamin therapy, biostimulants, magnetic stimulation, and reflexology.
We do not use these drugs. We believe that most optic atrophies (with the exception of hereditary forms associated with glaucoma, tumor) are a consequence of the inflammatory process. Often, when examining the fundus, an ophthalmologist sees a pale disc. Inflammation of the optic nerve can be observed in upper segments optic nerve. And we can treat any inflammatory process using the HAT treatment system.

In the absence of neurological pathology, we conduct a trial treatment with Dexamethasone. If after 4 days of treatment there is at least a slight effect, detectable both clinically and subjectively, then we can begin NAT treatment.
With this system we are achieving fantastic results in treatment. We are able to not only stop the disease, but also visual acuity and field of view significantly improve. If the patient contacts us in a timely manner, visual acuity can reach 100%.

WHAT TO EXPECT FROM TREATMENT
If all conditions are correctly met, a significant improvement in vision occurs immediately 8 days after the start of treatment with HAT medicine.
Depending on various factors, such as timely treatment, the nature of the process, the degree of improvement in visual acuity varies, from 10% to 100%. But most importantly, our treatment prevents further progression of the condition.
Stable dynamics and further improvement in vision occurs over the next 6 months.
It should be noted that this effect when using this method, it is observed only if the atrophy of the optic nerve is of an inflammatory or traumatic nature.
If, due to the fault of the patient, there is a violation of the regime (we often observed this), then recovery does not occur. You just have to start all over again. We do not charge additional fees for this.

ATTENTION!!! YOU SHOULD KNOW THIS
We do not treat optic atrophy several times a year. We tell patients that if they experience deterioration in their vision, they should immediately contact us. If this really happens, we may repeat the treatment.From our extensive practice of treating optic atrophy, it should be noted that relapses are rare, but they are possible. This is often associated with a history of influenza or other viral infection. “Spontaneous” relapses are rarely observed.Patients have been monitored since 1999.

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

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

Anatomy

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

Functions

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

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

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

Damage to the optic nerves always affects the visual field

Determination of ongoing processes

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

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

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

Acquired dystrophy

Acquired nerve atrophies have an intraocular or descending cause.

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

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

Among inflammatory causes I most often call it iritis and cyclitis. Catarrh of the iris and ciliary body is accompanied by changes intraocular pressure, structures vitreous, thereby influencing the state of the optic disc.

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

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

Congenital optic atrophy

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

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

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

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

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

Features:

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

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

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

Symptoms

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

Consequences of atrophy

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

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

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

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

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

Treatment

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

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

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

Drug treatment

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

A breakthrough in the treatment of optic atrophy is associated with the use of nanotechnology, which involves the delivery medicinal product directly to the nerve with nanoparticles.

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

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

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

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

Physiotherapy

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

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

Surgical intervention

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

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

TO the latest methods includes stem cell treatment. They can integrate into damaged tissue and further stimulate its repair by secreting neurotrophic and other growth factors.

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

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

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

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

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

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

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

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

IN medical literature There is some confusion in the concepts of neuritis, neuropathy and atrophy of the optic nerves: somewhere they say that these are one and the same thing, and somewhere that these are three completely various diseases. However, they certainly have general essence, symptoms and treatment.

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

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

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

Optic nerve atrophy symptoms

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

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

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

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

Diagnostics

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

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

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

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

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

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

Causes of the disease

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

• Toxic blindness:

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

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

• Congenital pathologies.

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

• Injuries.

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

• Inflammation.

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

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

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

• Oncology.

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

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

Treatment of optic neuritis

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

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

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

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

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

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

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

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

All kinds of pinching, compression, tumors, vascular aneurysms near the optic nerve and others similar reasons atrophies are removed surgically.

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

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

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

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

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

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

This is such a huge complex of procedures that sometimes takes more than a year, is necessary not to restore vision, but simply to stop its loss.

Optic nerve atrophy in a child

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

Possible consequences and forecasts

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

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

Optic atrophy(optic neuropathy) is a disorder of the optic nerve. The optic nerve serves as a link between our eyes and the brain. - nothing more than long processes (axons) of retinal neurons that convert light into nerve impulses and transferred to the central part of the visual analyzer (brain). These processes gather into a single bundle (nerve) at the back of the eye, forming the optic disc there. There are more than a million fibers that make up the optic nerve, so the process of their death (atrophy) may proceed unnoticed by the Patient for some time.

Causes of optic nerve atrophy

Optic neuropathy is not a separate disease, but a possible result of many pathologies.

They call her the following groups reasons:

• Glaucoma (a disease of the visual system accompanied by increased intraocular pressure and optic nerve atrophy)
• Retinal pigmentary dystrophy
• Ischemia (lack of blood flow to the optic nerve)
• (inflammatory processes in the optic nerve)
• The effect of toxins (alcohol, nicotine, methanol, heavy metals)
• Myopia ( high degrees)
• Tumors of the nerve or surrounding tissue
• Traumatic brain injuries
• Meningitis
• Hereditary causes.

Optic nerve atrophy: forms of pathology

Depending on the causes of the disease and the time of contact with an ophthalmologist, optic nerve atrophy at the time of treatment may be:

• Hereditary or non-hereditary (acquired)
• Partial or complete (no vision)
• Primary or secondary
• Ascending (damage to retinal cells) and descending (damage to optic nerve fibers)
• Unilateral or bilateral (i.e., affecting one or both eyes)
• Stationary or progressive (determined during dynamic observation by an ophthalmologist).

Symptoms and diagnosis of optic atrophy

It is not easy for even the most vigilant Patient to suspect optic nerve atrophy. Its symptoms include: decreased visual acuity (not correctable with glasses and contact lenses), narrowing of visual fields (disappearance of lateral vision), disorder color vision, headache. Optic nerve atrophy is characterized by the inability to improve vision with glasses or lenses.

For optic neuropathy you need the following:

• Full diagnostic examination (mandatory with pupil dilation)
• OST ((OCT) of the optic nerve head (ONH))
• (field of view)

The most important signs of optic nerve atrophy are changes in the boundaries of the visual fields and the condition of the optic nerve head (pallor, changes in shape and clarity, swelling).

Treatment of optic atrophy

Used in the treatment of optic nerve atrophy different methods: medicinal, hardware and surgical.

Typically required A complex approach. It is necessary to eliminate the cause of the pathology and slow down the death of visual fibers as much as possible.

Optic nerve atrophy is helped in combination with taking prescribed medications, vitamins, and proper nutrition.

Basic techniques hardware treatment :

• Magnetic stimulation- effects on the optic nerve are variable magnetic field. The procedure improves blood supply, promotes saturation of nervous tissue with oxygen, and activates metabolic processes.
• Electrical stimulation- supplying electrical impulses to the eye through an electrode. The principle of operation is similar to magnetic stimulation.
• Laser stimulation is a non-contact procedure, stimulating a nerve through the eye tissue using a special emitter.
• Ultrasound therapy- exposure to the problem area with ultrasound. The technique stimulates blood circulation and metabolic processes in the optic nerve, increases the permeability of the blood-ophthalmic barrier and the sorption properties of eye tissue. However, it has limitations and is not suitable for all cases of atrophy.
• Drug electrophoresis - effects on eye tissue direct current low strength in combination with medications. The procedure is also aimed at improving blood supply and metabolic processes.
• Oxygen therapy- saturation of optic nerve tissue with oxygen to increase metabolism.

To establish the causes of optic nerve atrophy and select the optimal treatment, it is necessary to go to the Eye Clinic of Dr. Belikova. Experience shows that properly selected medications and hardware treatment sessions will help the Patient maintain and, if possible, improve vision without surgical intervention to eliminate the causes of the disease.

Do not “close your eyes” to visual discomfort - immediately contact an ophthalmologist! Timely consultation with a doctor and regular (once a year, unless otherwise recommended by your attending physician) preventive examinations are the key to the health of your eyes.

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

Causes

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

Lesions of the central nervous system are considered to be the main “culprits” for the development of atrophy, these include: tumors, syphilitic lesions, meningitis, brain abscesses, encephalitis, skull injuries, multiple. In addition, the reasons for the development of such an anomaly can be atherosclerosis, hypertonic disease, quinine poisoning, profuse bleeding, vitamin deficiencies.

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

Manifestations of the disease

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

A characteristic symptom of this pathology is uncorrectable vision loss. This symptom can appear different ways, depending on the type of atrophy. The progression of the disease leads to a continuous decrease in vision due to the death of the optic nerve, which ultimately leads to complete blindness. This process, as a rule, occurs either rapidly - in a few days, or gradually - over the course of months.

Partial atrophy of the optic nerve in its course always stops the process of vision deterioration at some stage, after which vision stabilizes. This makes it possible to distinguish between progressive and complete atrophy.

Visual impairments during the course of the disease are of a very diverse nature, including changes in visual fields (usually narrowing with loss of “lateral vision”), up to “tunnel vision”, when a person sees as if through a tube, i.e. only those objects that are directly in front of it. This condition is associated with the appearance of - dark spots There is any color vision disorder in any part of the visual field.

With CHAZN, changes in visual fields are not only “tunnel”, which is due to the localization of the pathological process. Thus, the development of scotomas before the eyes may indicate a change in the nerve fibers of the central part of the retina or the area immediately adjacent to it. When struck nerve fibers periphery, a narrowing of the visual fields develops, and when the lesions are deep enough, the disappearance of half the visual field is observed. These changes can develop in either one or both eyes.

Diagnosis of CHAZN

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

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

Diagnosis of optic atrophy is usually not difficult. To identify it, an examination is prescribed, including: determination of visual acuity, its fields, as well as tests for color perception. At the same time, it is necessary to carry out a test, which can reveal the characteristic pallor of the optic nerve head and some narrowing of the fundus. Intraocular pressure is measured.

Often, to clarify the diagnosis, it is prescribed X-ray examination(craniography with an image of the sella turcica), magnetic resonance or computed tomography brain, fluorescein angiographic or electrophysiological research methods, using contrast, when inspecting the patency of retinal vessels.

Also necessary are laboratory research- general blood test, its biochemistry, test for borelliosis, as well as syphilis.

Video about the latest developments in the treatment of CHAZN

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

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

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

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

1. As noted above, the main thing is the treatment of the disease that caused atrophy, therefore it is prescribed complex therapy With various shapes drugs: eye drops, injections (general and local), tablets, physiotherapy. Similar treatment aims to:
2. Improving blood circulation and vessels supplying the nerve. For this purpose they use vasodilators(complamin, no-shpu, nicotinic acid, papaverine, dibazol, halidor, aminophylline, sermion, trental), as well as anticoagulants (heparin or ticlid);
3. Improving tissue metabolic processes and activating the regeneration of affected tissues. For this, biogenic stimulants (aloe extract, peat, etc.), tamines (B1, B2, B6, ascorutin), enzymatic agents (fibrinolysin, lidase), essential amino acids ( glutamic acid), as well as immunostimulants (ginseng, eleuthorococcus);
4. Cupping inflammatory processes through hormonal drugs(dexamethasone, );
5. Improving the functions of the central nervous system (Cerebrolysin, nootropil, Fezam, emoxipin, Cavinton).

Any medications must be taken strictly according to the regimen prescribed by the attending physician after diagnosis. Since only a specialist can choose the optimal treatment, taking into account concomitant diseases.

At the same time, physiotherapeutic procedures and acupuncture may be prescribed; sessions of laser, magnetic, and electrical stimulation of optic nerve tissue.

Such treatment must be repeated in courses several times a year.

If there is an obvious decrease in vision, a disability group may be assigned.

Those who are blind due to disease and visually impaired are prescribed rehabilitation courses, which are aimed at eliminating or compensating for the limitations in life that have arisen due to loss of vision.

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

Where to treat?

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