Treatment of Optic Nerve Atrophy (ONA) in Germany
Best hospitals and doctors for optic nerve atrophy (ona) treatment in Germany
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Optic nerve atrophy is the outcome of many eye diseases. Atrophy causes a decrease in visual acuity, and these changes are usually irreversible. If left untreated, blindness will eventually develop. Due to the death of nervous tissues, optical signals no longer come from the eye to the brain, so a person does not see anything, even if the organ of vision itself is functioning normally. The treatment of optic nerve atrophy requires the elimination of the cause of this condition whenever possible and the cessation of the development of the disease. New treatments are very helpful for the improvement of visual acuity in many patients. You can undergo your treatment in Germany to expect the best results. You are welcome to visit the Booking Health website to find the cost of treatment in Germany and choose a medical care program at the best price.
Content
- Causes of optic nerve atrophy
- Treatment principles
- Treatment of glaucomatous optic nerve atrophy
- Treatment of hereditary forms of the disease
- Stem cell therapy
- Where to undergo treatment?
Causes of optic nerve atrophy
The elimination of the causes is the most important stage in optic nerve atrophy treatment because it eliminates the factor in the progression of the disease. Not all causes can be eliminated, but some diseases can really be controlled, and some can be completely cured.
The causes of optic nerve atrophy are quite varied. These may be as follows:
- glaucoma;
- vascular atherosclerosis;
- hereditary diseases;
- neurodegenerative diseases;
- injuries (orbital fractures and foreign bodies in the eye);
- brain tumors;
- intoxication;
- rheumatic diseases;
- infections;
- retinal diseases.
Treatment principles
The treatment of optic nerve atrophy is usually aimed at maintaining and improving visual function. As a rule, patients receive conservative therapy. Surgery is rarely required, but for some diseases it is a necessity. For example, surgery is often used to lower intraocular pressure in glaucoma.
Drug therapy is used for most types of optic nerve atrophy. It is aimed at improving the blood supply to tissues and normalizing metabolic activity in the nerve endings. Doctors prescribe patients neuroprotectors, vasodilators, antioxidants, vitamins, and drugs to improve their blood rheological properties.
Below are the features of visual atrophy treatment depending on the cause of the disease:
- if the pathology has an inflammatory origin, corticosteroids will be prescribed;
- hereditary neuropathies are often treated with stem cells and gene therapy;
- glaucoma requires surgery, although it can also be controlled with medications (eye drops that lower intraocular pressure);
- atherosclerosis requires the correction of dyslipidemia and control of blood pressure;
- in the case of the formation of blood clots that disrupt the blood supply to the nerve, antiplatelet agents may be prescribed;
- intoxication requires the elimination of a constant contact with toxic substances and procedures to cleanse the body of toxins (plasmapheresis or infusion therapy).
Physiotherapy methods can often be used to restore vision. They improve the blood supply to the nervous tissue and normalize metabolic processes. The main options for physiotherapy at hospitals in Germany are electrical neurostimulation, biocontrolled transcranial laser therapy, and pulsed magnetic therapy.
Treatment of glaucomatous optic nerve atrophy
Peripheral vision loss followed by "tunnel vision" and eventually irreversible blindness is a fate of all patients suffering from various forms of glaucoma, including primary open-angle glaucoma and normal tension (with normal intraocular pressure) glaucoma. These diseases are accompanied by the death of retinal ganglion cells and the rupture of their axonal connections with the brain due to the optic nerve damage and thinning.
Primary open-angle glaucoma is the most common form of the disease. It affects 80 million people worldwide. At the time of the detection of the disease, an average of 40% of visual acuity is already lost.
The main goal of the treatment of such patients is the control of intraocular pressure. Its decrease for every 1 mmHg leads to a slowdown in the rate of progression of optic nerve atrophy by 10%. This effect can be achieved with conservative methods. Doctors at hospitals in Germany use the following drugs:
- carbonic anhydrase inhibitors;
- beta blockers;
- alpha-2-agonists;
- drugs that stimulate aqueous humor outflow through the trabecular meshwork;
- FP receptor agonists.
All of these medications have side effects, both local and systemic. In addition, they do not always achieve complete control of intraocular pressure, and require discipline from a patient for the regular use of drugs and monitoring the effectiveness of visual atrophy treatment.
Surgery that normalizes aqueous humor outflow for a long time is more effective. After the operation, a patient does not need any drugs, or the need for them is minimal. The effect lasts for several years, and sometimes for life. Patients often have drainage devices placed in their anterior chamber of the eye to allow aqueous humor drainage. Healthcare professionals at German ophthalmological clinics use the latest devices that provide an intraocular pressure reduction of 10-13 mmHg. Many anti-glaucoma operations have been developed that normalize blood pressure. Timely surgery stops optic nerve atrophy.
Treatment of hereditary forms of the disease
Hereditary optic neuropathies may manifest themselves as isolated optic nerve atrophy or cause multiple symptoms in other organs. The most common diseases with isolated optic nerve lesions are Leber hereditary optic neuropathy and dominant optic atrophy. Leber hereditary optic neuropathy (LHON) is caused by primary mutations in mitochondrial DNA. Up to 95% of all cases are due to mutations in three genes, and in 70% of cases, the cause is a mutation in the OPA1 gene.
Since 2015, hospitals in Germany have been using a drug called idebenone, which has dramatically improved the results in the fight against this form of optic nerve atrophy. It is a synthetic short-chain analogue of ubiquinone with antioxidant properties. It increases the rate of recovery, especially when used in the acute stage.
A significant advance in the treatment of hereditary optic atrophy is expected from gene therapy. The essence of the treatment method consists of intravitreal injections (injections into the vitreous body of the eye) of modified adeno-associated viral vectors. They deliver the missing genes needed to perform their functions to the mitochondria. Many gene therapy trials have already been successfully completed or are ongoing in Europe, the US, and China.
Stem cell therapy
At some specialized centers, the treatment of optic nerve atrophy in Germany is carried out with stem cells. This approach to therapy is not yet standard, and it is still used as part of clinical trials.
Any other cells, including neurons, can develop from stem cells. They can be implanted in the optic nerve, replacing defects. Stem cells also produce growth factors that stimulate tissue regeneration, relieve inflammation, and increase blood flow. The treatment does not provide an instant result, and it can only be achieved after a few weeks, but it lasts for at least several months. Stem cells not only stop the progression of the disease but can even improve visual acuity.
Basically, doctors use autologous (the patient's own) cells of various origins. They are administered using retrobulbar, subtenon, intravenous, intravitreal, and intraocular injections. That is, the cells can be used systemically or injected into different spaces of the eye.
Treatment results are as follows:
- increased macular and optic nerve thickness;
- improved visual acuity;
- field of view expansion.
The best results can be achieved for hereditary neuropathies. For example, in 2019, the results of the SCOTS study were published, according to which in 83.3% of cases, patients improved their vision in both eyes, and this improvement was maintained for at least 2 years of medical supervision. The mean improvement was 2.125 lines according to a Snellen chart, or 10.63 letters.
Where to undergo treatment?
You can undergo your optic nerve atrophy diagnostics and treatment of this disease with the help of drugs, surgery, stem cells, and other methods at hospitals in Germany. There are a few reasons for you to get medical care in this country. These are as follows:
- high-precision diagnostics help to determine the cause of optic nerve atrophy in most patients;
- treatment is aimed at eliminating the cause of the disease, if possible;
- treatment in Germany is carried out with the latest drugs, many of which are not yet used in countries with poor medical development;
- doctors at hospitals in Germany use advanced treatments, including stem cells and gene therapy;
- with the help of modern drugs, procedures, and operations, physicians at hospitals in Germany can not only stop the progression of the disease but can also improve visual acuity.
You are welcome to visit the Booking Health website to find the cost of treatment in Germany and compare prices. The specialists from the Booking Health company will help you to choose a hospital in Germany where you can expect the best results. When making your treatment appointment through the Booking Health service, the cost of treatment in Germany will be lower due to the absence of additional fees for foreign patients. The Booking Health staff will take care of the arrangements for your trip, and you can fully focus on restoring your health.
Authors:
The article was edited by medical experts, board-certified doctors Dr. Sergey Pashchenko and Dr. Vadim Zhiliuk. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
Sources:
British Journal of Ophthalmology
STEM CELL TREATMENT of Optic Nerve Atrophy