About the disease
The optic nerve conducts nerve impulses from eyes to the brain. Its atrophy means the death of nerve fibers. As a result, narrowing of the visual fields, gradual decrease of visual acuity, and, finally, irreversible vision loss happen.
There are hereditary and sporadic forms of the disease. The sporadic one is more common. Optic nerve atrophy is associated with various pathological processes, such as infections, vascular disorders, autoimmune or demyelinating diseases. Degenerative processes of the optic nerve can also develop due to glaucoma, intoxication, brain tumors and other pathologies.
Symptoms
- Decreased visual acuity (this may be absent in the early disease period in the case of predominant lesion of nerve fibers coming from the peripheral parts of retina).
- Visual field narrowing.
- Loss of the central vision.
- Color vision deficiency. More often, patients poorly distinguish green and red colors, less often – blue and yellow colors.
- Reduction of the pupil reaction to the light in preserved consensual pupillary light reflex.
Diagnosis
- Taking medical history. The doctor asks the patient about accompanying illnesses, traumatic brain injuries, and visual impairment in great detail.
- Ophthalmoscopy. The doctor sees pale disc of the optic nerve and narrowed vessels. In case of severe atrophic processes disk becomes white. It may have gray or a blue tint.
- The examination of the visual evoked potentials demonstrates decreased electrical activity of the visual cortex during optic nerve stimulation.
- Optical coherence tomography (OCT) allows doctor to receive an image of the optic nerve at the microscopic level and evaluate its structure.
- Fluorescein retinal angiography is used for differential diagnostics with edema, optic neuritis, and ischemic neuropathy.
- Dopplerography allows the doctor to assess blood flow in the intracranial part of the internal carotid artery, orbital and supratrochlear arteries.
Treatment
- Treatment of the main disease. It is necessary to eliminate the cause of atrophy in order to prevent further death of the nerve. This process includes treatment of the infectious disease, glaucoma correction, removal of a tumor or aneurysm, etc.
- Conservative therapy includes usage of drugs in order to improve blood circulation. These include angioprotectors, nootropics, and neurotropic drugs.
- Physiotherapy allows doctor to improve blood flow and slow down the atrophic processes of the optic nerve. Electrostimulation of the optic nerve, laser and magnetic therapy are performed. In case of partial atrophy due to the optochiasmatic arachnoiditis, electrophoresis with enzymes, vasodilators, and nootropic drugs is carried out.
- Stem cell therapy. Steam cells are taken from patient's body and injected into the sub-Tenon’s space of the eye. Stem cells stimulate regeneration of the nerve fibers, improve vision, and prevent further degenerative processes.
Authors: Dr. Vadim Zhiliuk, Dr. Sergey Pashchenko
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