Optic nerve atrophy: treatment, symptoms, causes of complete or partial damage. Symptoms and treatment of optic nerve atrophy Causes of optic nerve atrophy in adults

19-12-2012, 14:49

Description

Etiology

Development of optic nerve atrophy cause 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.

lead to optic nerve atrophy common diseases. This happens with poisoning with ethyl and methyl alcohols, tobacco, quinine, chlorophos, sulfonamides, lead, carbon disulfide and other substances, with botulism. Vascular diseases can cause acute or chronic circulatory disorders in the vessels of the optic nerve with the development of ischemic foci and softening foci in it (colliquation necrosis). Essential and symptomatic hypertension, atherosclerosis, diabetes mellitus, internal profuse bleeding, anemia, diseases of the cardiovascular system, starvation, beriberi can lead to atrophy of the optic nerve.

In the etiology of optic nerve atrophy are important and diseases of the eyeball. These are lesions of the retina of vascular origin (with hypertensive angiosclerosis, atherosclerosis, involutional changes), retinal vessels (inflammatory and allergic vasculitis, obstruction of the central artery and central vein of the retina), degenerative diseases of the retina (including retinitis pigmentosa), complications of uveitis (papillitis, chorioretinitis), retinal detachment, primary and secondary glaucoma (inflammatory and post-inflammatory, flicogenic, vascular, dystrophic, traumatic, postoperative, neoplastic). Prolonged hypotension of the eyeball after surgery, inflammatory degenerative diseases of the ciliary body, penetrating wounds of the eyeball with the formation of a fistula lead to edema of the optic nerve head (stagnant nipple), after which atrophy of the optic nerve head develops.

In addition to Leber's hereditary atrophy and hereditary infantile optic atrophy, hereditary causes play a role in the occurrence of atrophy in drusen of the optic nerve head. Diseases and deformities of the bones of the skull (tower-shaped skull, Crouzon's disease) also lead to atrophy of the optic nerves.

It should be noted that in practice the etiology of optic nerve atrophy is not always easy to establish. According to E. Zh. Tron, in 20.4% of patients with atrophy of the optic nerves, its etiology was not established.

Pathogenesis

The nerve fibers of the peripheral neuron of the visual pathway can be exposed to various influences. These are inflammation, non-inflammatory edema, dystrophy, circulatory disorders, the action of toxins, damage, compression (tumor, adhesions, hematomas, cysts, sclerotic vessels, aneurysms), which leads to the destruction of nerve fibers and their replacement with glial and connective tissue, obliteration of the capillaries that feed them .

In addition, with an increase in intraocular pressure, it develops collapse of the glial cribriform membrane of the optic disc, which leads to degeneration of nerve fibers in vulnerable areas of the disc, and then to disc atrophy with excavation resulting from direct compression of the disc and secondary microcirculation disorders.

Classification

On the ophthalmoscopic picture, they distinguish primary (simple) and secondary atrophy of the optic nerve. Primary atrophy occurs on a disc that has not been changed before. With simple atrophy, nerve fibers are promptly replaced by proliferating elements of glia and connective tissue that take their places. The borders of the disk remain distinct. Secondary atrophy of the optic disc occurs on the altered disc due to its edema (congestive nipple, anterior ischemic neuropathy) or inflammation. In place of the dead nerve fibers, as in primary atrophy, glia elements penetrate, but this occurs more rapidly and in large sizes, as a result of which rough scars are formed. The boundaries of the optic nerve head are not distinct, washed away, its diameter can be increased. The division of atrophy into primary and secondary is conditional. With secondary atrophy, the borders of the disk are only fuzzy at the beginning, with time the edema disappears, and the borders of the disk become clear. Such atrophy is no different from simple. Sometimes glaucomatous (marginal, cavernous, cauldron-shaped) atrophy of the optic nerve head is isolated in a separate form. With it, there is practically no proliferation of glia and connective tissue, and as a result of direct mechanical action of increased intraocular pressure, the optic disc is squeezed (excavated) as a result of the collapse of its glial lattice membrane.

Atrophy of the optic disc, depending on the degree of color loss detected during ophthalmoscopy, is divided into initial, partial, incomplete and complete. With initial atrophy, against the background of a pink disc color, a slight blanching appears, which later becomes more intense. With the defeat of not the entire diameter of the optic nerve, but only part of it, partial atrophy of the optic nerve head develops. So, with the defeat of the papillomacular bundle, blanching of the temporal half of the optic disc occurs. With further spread of the process, partial atrophy can spread to the entire nipple. With diffuse spread of the atrophic process, uniform blanching of the entire disc is noted. If at the same time visual functions are still preserved, then they speak of incomplete atrophy. With complete atrophy of the optic nerve, the blanching of the disc is total and the visual functions of the affected eye are completely lost (amaurosis). In the optic nerve, not only visual, but also reflex nerve fibers pass, therefore, with complete atrophy of the optic nerve, the direct pupillary reaction to light is lost on the side of the lesion, and the friendly reaction is lost on the other eye.

Topically allocate ascending and descending optic nerve atrophy. Retinal ascending atrophy (wax, valerian) occurs in inflammatory and degenerative processes in the retina due to the primary lesion of the visual ganglionic neurocytes of the ganglionic layer of the retina. The optic disc becomes grayish-yellow, the vessels of the disc narrow, their number decreases. Ascending atrophy does not develop when only the neuroepithelial layer of the retina (rods and cones) is affected. Descending optic nerve atrophy occurs when a peripheral neuron of the optic pathway is damaged and slowly descends to the optic nerve head. Having reached the optic nerve head, the atrophic process changes it according to the type of primary atrophy. Descending atrophy spreads more slowly than ascending. The closer the process is to the eyeball, the faster the atrophy of the optic disc appears in the fundus. Thus, damage to the optic nerve at the point of entry into it of the central retinal artery (10-12 mm behind the eyeball) causes atrophy of the optic nerve head in 7-10 days. Damage to the intraorbital segment of the optic nerve before the entry of the central retinal artery into it leads to the development of atrophy of the optic nerve head in 2-3 weeks. With retrobulbar neuritis, atrophy descends to the fundus of the eye within 1-2 months. With injuries of the chiasm, descending atrophy descends to the fundus 4-8 weeks after the injury, and with slow compression of the chiasm by pituitary tumors, atrophy of the optic disc develops only after 5-8 months. Thus, the rate of spread of descending atrophy is also related to the type and intensity of the pathological process that affects the peripheral neuron of the visual pathway. They matter and blood supply conditions: the atrophic process develops faster with a deterioration in the blood supply to the nerve fibers. Atrophy of the optic discs in case of damage to the optic tract occurs about a year after the onset of the disease (with injuries of the optic tract, somewhat faster).

Optic atrophy may be stationary and progressive, which is evaluated in the process of dynamic examination of the fundus and visual functions.

When one eye is affected, it is said unilateral, with damage to both eyes - o bilateral optic nerve atrophy. Atrophy of the optic nerves in intracranial processes is more often bilateral, but the degree of its severity is different. Occurs with intracranial processes and unilateral atrophy of the optic nerve, which is especially common when the pathological focus is localized in the anterior cranial fossa. Unilateral atrophy in intracranial processes may be the initial stage of bilateral. In violation of blood circulation in the vessels of the optic nerve, intoxication, the process is usually bilateral. Unilateral atrophy occurs with damage to the optic nerve, pathological processes in the orbit, or due to unilateral pathology of the eyeball.

Ophthalmoscopic picture

With optic nerve atrophy, there is always blanching of the optic disc a. Often, but not always, there is vasoconstriction of the optic disc.

With primary (simple) atrophy the borders of the disk are clear, its color is white or grayish-white, bluish or slightly greenish. In redless light, the contours of the disk remain clear or become sharper, while the contours of a normal disk are veiled. In red (purple) light, the atrophic disc becomes blue. The cribriform plate (lamina cribrosa), through which the optic nerve passes when it enters the eyeball, is very little translucent. The translucence of the cribriform plate is due to a decrease in the blood supply to the atrophied disc and less than with secondary atrophy, the growth of glial tissue. Disc blanching can vary in intensity and distribution. With initial atrophy, a slight but distinct blanching appears against the background of the pink color of the disc, then it becomes more intense with a simultaneous weakening of the pink tint, which then completely disappears. With advanced atrophy, the disc is white. At this stage of atrophy, vasoconstriction is almost always noted, and the arteries are narrowed more sharply than the veins. The number of vessels on the disk also decreases. Normally, about 10 small vessels pass through the edge of the disc. With atrophy, their number decreases to 7-6, and sometimes up to three (Kestenbaum's symptom). Sometimes with primary atrophy, a slight excavation of the optic nerve head is possible.

With secondary atrophy disk borders are indistinct, washed away. Its color is gray or dirty gray. The vascular funnel or physiological excavation is filled with connective or glial tissue, the cribriform plate of the sclera is not visible. These changes are usually more pronounced in atrophy after congestive nipple than in atrophy after optic neuritis or anterior ischemic neuropathy.

Retinal wax atrophy of the optic disc distinguished by its yellow wax color.

With glaucoma increased intraocular pressure causes the appearance of glaucomatous excavation of the optic disc. In this case, at first the vascular bundle of the disc is displaced to the nasal side, then excavation of the nipple gradually develops, which gradually increases. The color of the disc becomes whitish and pale. The excavation in the form of a cauldron covers almost the entire disc to its edges (cauldron-shaped, marginal excavation), which distinguishes it from the physiological excavation, which has the shape of a funnel that does not reach the edges of the disc and does not displace the vascular bundle to the nasal side. Vessels at the edge of the disk are bent over the edge of the recess. In advanced stages of glaucoma, the excavation captures the entire disc, which becomes completely white, and the vessels on it are severely constricted.

Cavernous atrophy occurs when the vessels of the optic nerve are damaged. The atrophic optic disc begins to bulge under the influence of normal intraocular pressure with the appearance of excavation, while excavation of a normal disc requires increased intraocular pressure. Excavation of the disc in cavernous atrophy is facilitated by the fact that the growth of glia is small, and therefore no additional resistance is created to prevent excavation.

visual functions

Visual acuity of patients with optic nerve atrophy depends on the location and intensity of the atrophic process. If the papillomacular bundle is affected, then visual acuity is significantly reduced. If the papillomacular bundle is affected slightly, and the peripheral fibers of the optic nerve suffer more, then visual acuity does not decrease much. If there is no damage to the papillomacular bundle, and only the peripheral fibers of the optic nerve are affected, then visual acuity does not change.

Visual field changes with atrophy of the optic nerve are important in topical diagnosis. They depend to a greater extent on the localization of the pathological process and to a lesser extent on its intensity. If the papillomacular bundle is affected, then a central scotoma occurs. If the peripheral fibers of the optic nerve are affected, then narrowing of the peripheral boundaries of the visual field develops (uniform along all meridians, uneven, sector-shaped). If atrophy of the optic nerve is associated with damage to the chiasm or the optic tract, then hemianopia (homonymous and heteronymous) occur. Hemianopia in one eye occurs when the intracranial part of the optic nerve is affected.

Disorders of color vision more often occur and are clearly expressed with atrophy of the optic nerve head that occurs after neuritis, and rarely with atrophy after edema. First of all, the color perception for green and red suffers.

Often with atrophy of the optic nerves changes in the fundus correspond to changes in visual functions, but this is not always the case. So, with descending atrophy of the optic nerve, visual functions can be greatly changed, and the fundus of the eye remains normal for a long time until the atrophic process descends to the optic nerve head. Perhaps a pronounced blanching of the optic nerve head in combination with a slight change in visual functions. This can be with multiple sclerosis, when the death of myelin sheaths in the plaque area occurs while the axial cylinders of nerve fibers are preserved. Pronounced blanching of the disc with the preservation of visual functions may also be associated with the peculiarity of the blood supply in the region of the cribriform plate of the sclera. This area is supplied with blood from the posterior short ciliary arteries, the deterioration of blood flow through them causes intense blanching of the disc. The rest (orbital) part of the optic nerve is supplied with blood from the anterior and posterior arteries of the optic nerve, that is, from other vessels.

With blanching of the optic nerve head, combined with the normal state of visual functions, it is necessary to study the visual field using campimetry to detect small visual defects. In addition, you need to collect an anamnesis about the initial visual acuity, since sometimes visual acuity can be higher than one, and in these cases, its decrease to one may indicate the influence of an atrophic process.

With unilateral atrophy a thorough study of the functions of the second eye is necessary, since unilateral atrophy can only be the beginning of bilateral, which often happens with intracranial processes. Changes in the visual field of the other eye indicate a bilateral process and acquire important topical diagnostic value.

Diagnostics

In severe cases, diagnosis is not difficult. If the pallor of the optic disc is insignificant (especially temporal, since the temporal half of the disc is normally somewhat paler than the nasal one), then a long-term study of visual functions in dynamics helps to establish the diagnosis. At the same time, it is necessary pay special attention to the study of the field of view for white and colored objects. Facilitate diagnosis Electrophysiological, X-ray and fluorescent angiographic studies. Characteristic changes in the visual field and an increase in the threshold of electrical sensitivity (up to 400 μA at a norm of 40 μA) indicate atrophy of the optic nerve. The presence of marginal excavation of the optic disc and an increase in intraocular pressure indicate glaucomatous atrophy.

Sometimes it is difficult only by the presence of atrophy of the disc in the fundus to establish the type of lesion of the optic nerve or the nature of the underlying disease. Washing out of the borders of the disc during atrophy indicates that it was the result of edema or inflammation of the disc. It is necessary to study the anamnesis in more detail: the presence of symptoms of intracranial hypertension indicates the post-congestive nature of the atrophy. The presence of simple atrophy with clear boundaries does not exclude its inflammatory origin. So, descending atrophy on the basis of retrobulbar neuritis and inflammatory processes of the brain and its membranes causes disc changes in the fundus of the eye according to the type of simple atrophy. The nature of atrophy(simple or secondary) is of great importance in diagnosis, since certain diseases lead to certain, “favorite” types of damage to the optic nerves. For example, compression of the optic nerve or chiasm by a tumor leads to the development of simple atrophy of the optic nerves, tumors of the ventricles of the brain - to the development of congestive nipples and then to secondary atrophy. However, the diagnosis is complicated by the fact that some diseases, such as meningitis, arachnoiditis, neurosyphilis, can be accompanied by both simple and secondary atrophy of the optic discs. In this case, concomitant eye symptoms matter: changes in the vessels of the retina, the retina itself, the choroid, as well as a combination of atrophy of the optic nerves with a disorder of pupillary reactions.

When assessing the degree of color loss and blanching of the optic disc it is necessary to take into account the general background of the fundus. Against the parquet background of the fundus in brunettes, even a normal or slightly atrophied disc appears paler and whiter. Against a light background of the fundus, the atrophic nipple may not look so pale and white. In severe anemia, the optic discs are completely white, but more often a faint pink tint is retained. In hypermetropes, the optic discs in the normal state are more hyperemic, and with a high degree of hypermetropia, there may be a picture of false neuritis (severe hyperemia of the nipples). In myopia, the optic discs are paler than in emmetropes. The temporal half of the optic disc is normally slightly paler than the nasal one.

Optic nerve atrophy in some diseases

brain tumors . Secondary atrophy of the optic nerve in brain tumors is a consequence of congestive nipples. More often it happens with tumors of the cerebellopontine angle, hemispheres and ventricles of the brain. With subtentorial tumors, secondary atrophy is less common than with supratentorial ones. The incidence of secondary atrophy is affected not only by the location, but also by the nature of the tumor. It is more common in benign tumors. Especially rarely, it develops with metastases of malignant tumors in the brain, since death occurs earlier than congestive nipples turn into secondary atrophy.

Primary (simple) atrophy of the optic nerve occurs when compression of a peripheral neuron of the optic pathway. Most often, the chiasm is affected, less often the intracranial part of the optic nerve, and even more rarely the optic tract. Simple atrophy of the optic nerve is characteristic of supratentorial brain tumors, especially often it is caused by tumors of the chiasmal-sellar region. Rarely, primary atrophy of the optic nerves occurs with subtentorial tumors as a symptom at a distance: compression of the peripheral neuron of the optic pathway is carried out through an expanded ventricular system or by dislocation of the brain. Primary optic nerve atrophy rarely occurs with tumors of the ventricles of the cerebral hemispheres, cerebellum and cerebellopontine angle, and secondary atrophy in tumors of this localization is common. Rarely, simple atrophy of the optic nerves develops in malignant tumors and often in benign ones. Primary atrophy of the optic nerves is usually caused by benign tumors of the sella turcica (pituitary adenomas, craniopharyngiomas) and meningiomas of the lesser wing of the sphenoid bone and olfactory fossa. Optic nerve atrophy develops in Foster Kennedy syndrome: simple atrophy in one eye and congestive nipple with a possible transition to secondary atrophy in the other eye.

brain abscesses . Congestive discs often develop, but they rarely progress to secondary optic atrophy, since the increase in intracranial pressure is not so long-lasting, because intracranial hypertension either decreases after surgery, or patients do not live to see congestive nipples turn into secondary atrophy. Rarely, Foster Kennedy syndrome occurs.

Optochiasmatic arachnoiditis . More often, primary atrophy of the optic discs occurs in the form of blanching of the entire nipple or its temporal half (partial atrophy). In isolated cases, blanching of the upper or lower half of the disc is possible.

Secondary atrophy of the optic discs in optochiasmal arachnoiditis can be postneuritic (transition of inflammation from the meninges to the optic nerve) or postcongestive (occurs after congestive nipples).

Arachnoiditis of the posterior cranial fossa . Often lead to the development of pronounced congestive nipples, which then turn into secondary atrophy of the optic discs.

Aneurysms of the vessels of the base of the brain . Anterior circle of Willis aneurysms often press on the intracranial optic nerve and chiasm, resulting in simple optic atrophy. Simple atrophy due to compression of the optic nerve is unilateral, always located on the side of the aneurysm. With pressure on the chiasm, bilateral simple atrophy occurs, which may first occur in one eye and then appear in the other. Unilateral simple atrophy of the optic nerve most often occurs with aneurysms of the internal carotid artery, less often with aneurysms of the anterior cerebral artery. Aneurysms of the vessels of the base of the brain are most often manifested by unilateral paralysis and paresis of the nerves of the oculomotor apparatus.

Thrombosis of the internal carotid artery . The presence of an alternating opto-pyramidal syndrome is characteristic: blindness of the eye with simple atrophy of the optic disc on the side of thrombosis, combined with hemiplegia on the other side.

Tabes dorsalis and progressive paralysis . In tabes and progressive paralysis, atrophy of the optic nerves is usually bilateral and has the character of simple atrophy. Atrophy of the optic nerves in tabes is more common than in progressive paralysis. The atrophic process begins with peripheral fibers and then slowly goes deep into the optic nerve, so there is a gradual decrease in visual functions. Visual acuity gradually decreases with varying degrees of severity in both eyes up to bilateral blindness. Fields of vision gradually narrow, especially on colors, in the absence of cattle. Atrophy of the optic nerve with tabes usually develops in the early period of the disease, when other neurological symptoms (ataxia, paralysis) are not expressed or absent. Tabes is characterized by a combination of simple optic nerve atrophy with Argil Robertson's symptom. Reflex immobility of the pupils in tabes is often combined with miosis, anisocoria, and pupillary deformity. Argil Robertson's symptom also occurs with syphilis of the brain, but much less frequently. Secondary atrophy of the optic discs (postcongestive and postneuritic) speaks against tabes and often occurs with cerebral syphilis.

Atherosclerosis . Atrophy of the optic nerve in atherosclerosis occurs as a result of direct compression of the optic nerve by a sclerotic carotid artery or as a result of damage to the vessels supplying the optic nerve. Primary atrophy of the optic nerve develops more often, secondary atrophy is much less common (after disc edema due to anterior ischemic neuropathy). Often there are sclerotic changes in the vessels of the retina, but these changes are also characteristic of syphilis, hypertension and kidney disease.

Hypertonic disease . Optic nerve atrophy may be due to neuroretinopathy. This is secondary disc atrophy with accompanying symptoms characteristic of hypertensive angioretinopathy.

With hypertension, optic nerve atrophy may occur as an independent process, not associated with changes in the retina and retinal vessels. In this case, atrophy develops due to damage to the peripheral neuron of the visual pathway (nerve, chiasm, tract) and is in the nature of primary atrophy.

Profuse bleeding . After profuse bleeding (gastrointestinal, uterine) after a more or less long time, from several hours to 3-10 days, anterior ischemic neuropathy may develop, after which secondary atrophy of the optic discs develops. The lesion is usually bilateral.

Leber's optic nerve atrophy . Family hereditary atrophy of the optic nerves (Leber's disease) is observed in men aged 16-22 years in several generations and is transmitted through the female line. The disease proceeds as a bilateral retrobulbar neuritis, starting with a sharp drop in vision. A few months later, simple atrophy of the optic discs develops. Sometimes the entire nipple turns pale, sometimes only the temporal halves. Complete blindness usually does not occur. Some authors believe that Leber's atrophy is a consequence of optochiasmal arachnoiditis. The type of inheritance is recessive, linked to the X chromosome.

Hereditary infantile optic nerve atrophy . Children 2-14 years old are ill. Gradually, simple atrophy of the optic nerves develops with temporal blanching of the disc, less often the nipple. Often, high visual acuity is preserved, there is never blindness in both eyes. Often there are central scotomas in the field of view of both eyes. Color perception is usually impaired, and more blue than red and green. The type of inheritance is dominant, that is, the disease is transmitted from sick fathers and sick mothers to both sons and daughters.

Diseases and deformities of the bones of the skull . In early childhood, with a tower-shaped skull and Crouzon's disease (craniofacial dysostosis), congestive nipples may develop, after which secondary atrophy of the optic discs of both eyes develops.

Principles of treatment

Treatment of patients with atrophy of the optic nerves is carried out taking into account its etiology. Patients with optic nerve atrophy, which has developed due to compression of the peripheral neuron of the optic pathway by the intracranial process, require neurosurgical treatment.

To improve the blood supply to the optic nerve use vasodilators, vitamin preparations, biogenic stimulants, neuroprotectors, infusion of hypertonic solutions. Perhaps the use of oxygen therapy, blood transfusions, the use of heparin. In the absence of contraindications, physiotherapy is used: ultrasound on the open eye and endonasal drug electrophoresis of vasodilators, vitamin preparations, lecozyme (papain), lidase; apply electrical and magnetic stimulation of the optic nerves.

Forecast

Prognosis of optic nerve atrophy always serious. In some cases, you can count on the preservation of vision. With developed atrophy, the prognosis is unfavorable. Treatment of patients with atrophy of the optic nerves, whose visual acuity was less than 0.01 for several years, is ineffective.

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Optic nerve atrophy is a condition in which there is a partial or complete destruction of nerve fibers and their replacement with dense connective tissue elements.

Causes and provoking factors

The following factors can lead to atrophy of the optic nerve:

It should be noted that in more than 20% of cases it is not possible to determine the cause of optic nerve atrophy.

Classification

Depending on the time of occurrence optic nerve atrophy is:

• Acquired;
• Congenital, or hereditary.

According to the mechanism of occurrence Optic nerve atrophy is divided into two types:

• Primary. Occurs in a healthy eye and is caused, as a rule, by a violation of microcirculation and nerve nutrition. It is divided into ascending (retinal cells are affected) and descending (the fibers of the optic nerve are directly damaged);
• Secondary. Occurs against the background of eye diseases.

Separately, glaucomatous atrophy of the optic nerve is distinguished. As you know, this disease is accompanied by an increase in intraocular pressure. As a result, the lamina cribrosa is gradually destroyed - the anatomical structure through which the optic nerve enters the cranial cavity. A characteristic feature of glaucomatous atrophy is that vision is preserved for a long time.

Depending on the preservation of visual functions atrophy happens:

• Complete when a person absolutely does not perceive light stimuli;
• Partial, at which separate sections of the visual fields are preserved.

Symptoms of optic nerve atrophy

The clinical picture of optic nerve atrophy depends on the type and extent of damage to the nerve structures.

Atrophy is accompanied by a gradual narrowing of the visual fields and a decrease in visual acuity. As the disease progresses, it becomes difficult for a person to distinguish colors. With partial atrophy of the optic nerve, scotomas appear -.

Almost all patients report visual impairment at dusk and in poor artificial lighting.

Features of the disease in children

If there is congenital atrophy, then it begins to manifest itself from the first months of the baby's life. Parents notice that the child does not follow the toys, does not recognize loved ones. This indicates a marked decrease in visual acuity. It happens that the disease is accompanied by total blindness.

Older children may complain of headaches, the appearance of dark or black areas in the field of vision. Almost everyone has difficulty recognizing colors.

Unfortunately, congenital atrophy of the optic nerve in a child is practically not amenable to correction. However, the sooner the child is examined by a specialist, the more likely it is to stop the development of the disease.

Diagnosis of the disease

Fundus ophthalmoscopy plays a key role in the diagnosis. This is a fairly simple and affordable method that allows you to reliably establish a diagnosis.

If a person has primary atrophy, the doctor sees a blanching of the optic nerve head in the fundus, as well as a narrowing of the blood vessels. Secondary atrophy is also accompanied by disc pallor, however, there will be an expansion of blood vessels caused by concomitant diseases. The borders of the disc are vague, there may be pinpoint hemorrhages on the retina.

Compare the fundus of a healthy person and a person with atrophy:

For complex diagnostics, the following methods are also used:

• Measurement of intraocular pressure (tonometry);
• Perimetry (assessment of visual fields);
• Plain radiograph of the skull (with suspicion of trauma or tumor-like formations);
• Fluorescent angiography (allows you to assess the patency of blood vessels);
• Doppler ultrasound (used for suspected blockage of the internal carotid artery);
• Computed or magnetic resonance imaging.

Often, to clarify the diagnosis, a consultation with a neuropathologist, rheumatologist, traumatologist or neurosurgeon is required.

Treatment of optic nerve atrophy

Treatment of optic nerve atrophy is not possible

Unfortunately, to date, not a single doctor has succeeded in curing optic nerve atrophy. No wonder there is an opinion in the world that nerve cells cannot be restored. Therefore, the main goal of treatment is to preserve the surviving nerve fibers and prevent them from atrophying. At the same time, it is extremely important not to waste time. First of all, it is necessary to establish what caused the disease, and to treat comorbidities. This is especially true of drug correction of diabetes mellitus and hypertension.

In general, ensure The functioning of the optic nerve can be done in two ways: with the help of surgical intervention and conservative methods (drug and physiotherapy treatment).

Conservative treatment

In complex treatment, depending on the indications of the doctor, the following groups of drugs are used:

Good results show physiotherapy methods of treatment, such as acupuncture, laser stimulation, electrophoresis, magnetotherapy, electrical stimulation.

Surgical intervention

Surgical treatment of optic nerve atrophy is indicated mainly in the presence of tumor-like neoplasms that somehow affect the optic nerve. Surgical tactics are also resorted to in case of anomalies in the development of the eye and some ophthalmic diseases.

A rapid decrease in vision may indicate various eye diseases. But rarely does anyone think that it can be caused by such a dangerous disease as optic nerve atrophy. The optic nerve is an important component in the perception of light information. Therefore, it is worth considering this disease in more detail so that it is possible to determine the symptoms in the early stages.

What it is?

The optic nerve is a nerve fiber responsible for processing and transmitting light information. The main function of the optic nerve is the delivery of nerve impulses to the region of the brain.

The optic nerve is attached to the ganglionic neurocytes of the retina, which make up the optic nerve head. Light rays, converted into a nerve impulse, are transmitted along the optic nerve from retinal cells to the chiasm (the segment where the optic nerves of both eyes intersect).

Where is the optic nerve

Its integrity provides high. However, even the smallest injury to the optic nerve can lead to serious consequences. The most common disease of the optic nerve is its atrophy.

Optic nerve atrophy is an eye disease in which degradation of the optic nerve occurs, followed by a decrease in vision. With this disease, the optic nerve fibers completely or partially die off and are replaced by connective tissue. As a result, the light rays falling on the retina of the eye are converted into an electrical signal with distortions, which narrows the field of view and reduces its quality.

Depending on the degree of damage, atrophy of the optic nerve is partial or complete. Partial atrophy of the optic nerve differs from complete atrophy by a less pronounced manifestation of the disease and the preservation of vision at a certain level.

Vision correction by traditional methods (, contact lenses) for this disease is absolutely ineffective, since they are aimed at correcting the refraction of the eye and have nothing to do with the optic nerve.

Causes

Optic nerve atrophy is not an independent disease, but is a consequence of any pathological process in the patient's body.

optic nerve atrophy

The main causes of the disease include:

• Eye diseases (diseases of the retina, eyeball, eye structures).
• Pathologies of the central nervous system (brain damage due to syphilis, brain abscess, skull trauma, brain tumors, multiple sclerosis, encephalitis, meningitis, arachnoiditis).
• Diseases of the cardiovascular system (atherosclerosis of cerebral vessels, arterial hypertension, vasospasm).
• Long-term toxic effects of alcohol, nicotine and drugs. Alcohol poisoning with methyl alcohol.
• hereditary factor.

Optic nerve atrophy can be congenital or acquired.

Congenital atrophy of the optic nerve occurs as a result of genetic diseases (in most cases, Leber's disease). In this case, the patient has a poor quality of vision from birth.

Acquired atrophy of the optic nerve appears due to certain diseases at an older age.

Symptoms

The main symptoms of partial atrophy of vision can be:

• Deterioration of the quality of vision and the inability to correct it with traditional methods of correction.
• Pain on moving the eyeballs.
• Changing the perception of colors.
• Narrowing of the visual fields (up to the manifestation of a tunnel syndrome, in which the ability to peripheral vision is completely lost).
• The appearance of blind areas in the field of view (scotomas).

Laser vision correction methods can be seen in.

Stages of optic nerve atrophy

Diagnostics

Usually, the diagnosis of this disease does not cause much difficulty. As a rule, the patient notices a significant decrease in vision and turns to an ophthalmologist who establishes the correct diagnosis. Of great importance is the identification of the cause of the disease.

To detect atrophy of the optic nerve in a patient, a complex of diagnostic methods is performed:

• (study of visual acuity).
• Spheroperimetry (determination of visual fields).
• Ophthalmoscopy (detection of blanching of the optic disc and narrowing of the vessels of the fundus).
• Tonometry (measurement of intraocular pressure).
• Video ophthalmography (examination of the relief of the optic nerve).
• (examination of areas of the affected nerve).
• Computed tomography and magnetic nuclear resonance (a study of the brain to identify possible causes that caused atrophy of the optic nerve).

Read what computer perimetry in ophthalmology determines.

In addition to an ophthalmological examination, the patient may be prescribed an examination by a neuropathologist or neurosurgeon. This is necessary for the reason that the symptoms of optic nerve atrophy may be symptoms of an incipient intracranial pathological process.

Treatment

Treatment of optic nerve atrophy is quite complicated. Destroyed nerve fibers cannot be restored, therefore, first of all, it is necessary to stop the process of changes in the tissues of the optic nerve. Since the nervous tissue of the optic nerve cannot be restored, visual acuity cannot be raised to its previous level. However, the disease must be treated to avoid its progression and the occurrence of blindness. The prognosis of the disease depends on the start of treatment, so it is advisable to immediately contact an ophthalmologist when the first symptoms of the disease are detected.

The difference between partial atrophy of the optic nerve and complete atrophy is that this form of the disease is treatable and it is still possible to restore vision. The main goal in the treatment of partial optic nerve atrophy is to stop the destruction of the tissues of the optic nerve.

The main efforts should be aimed at eliminating. Treatment of the underlying disease will stop the destruction of the tissues of the optic nerve and restore visual function.

Against the background of treatment of the underlying disease that caused atrophy of the optic nerve, complex therapy is carried out. Additionally, in the treatment, drugs can be used to improve blood supply and nutrition of the optic nerve, improve metabolism, eliminate swelling and inflammation. It will not be superfluous to use multivitamins and biostimulants.

As the main drugs use:

• Vasodilator drugs. These drugs improve blood circulation and trophism in the tissues of the optic nerve. Complamin, papaverine, dibazol, no-shpu, halidor, eufillin, trental, sermion can be distinguished among the drugs of this group.
• Drugs that stimulate the restoration of altered tissues of the optic nerve and improve metabolic processes in it. These include biogenic stimulants (peat, aloe extract), amino acids (glutamic acid), vitamins and immunostimulants (eleuthorococcus, ginseng).
• Drugs that resolve pathological processes and metabolism stimulants (phosphaden, pyrogenal, preductal).

It must be understood that drug therapy does not cure optic nerve atrophy, but only improves the condition of the nerve fibers. To cure optic nerve atrophy, it is necessary to first cure the underlying disease.

Physiotherapeutic procedures are also important, which are used in combination with other methods of treatment. Also, methods of magnetic, laser and electrical stimulation of the optic nerve are effective. They help to improve the functional state of the optic nerve and visual functions.

As an additional treatment, the following procedures are used:

• Magnetostimulation. In this procedure, the optic nerve is affected by a special device that creates an alternating magnetic field. Magnetostimulation helps to improve blood supply, saturate the tissues of the optic nerve with oxygen, and activate metabolic processes.
• Electrical stimulation. This procedure is carried out using a special electrode, which is inserted behind the eyeball to the optic nerve and electrical impulses are applied to it.
• Laser stimulation. The essence of this method is non-invasive stimulation of the optic nerve through the cornea or pupil using a special emitter.
• ultrasound therapy. This method effectively stimulates blood circulation and metabolic processes in the tissues of the optic nerve, improves the permeability of the hematoophthalmic barrier and the sorption properties of eye tissues. If the cause of optic nerve atrophy is encephalitis or tuberculous meningitis, then the disease will be quite difficult to treat with ultrasound.
• Electrophoresis. This procedure is characterized by the effect on the tissues of the eye of a direct current of low power and medicines. Electrophoresis promotes the expansion of blood vessels, improves cell metabolism and normalizes metabolism.
• Oxygen therapy. This method consists in saturating the tissues of the optic nerve with oxygen, which helps to improve their metabolic processes.

During the treatment of optic nerve atrophy, it is imperative to observe the full quality of nutrition, saturated with various vitamins and minerals. It is necessary to use fresh vegetables and fruits, cereals, meat, dairy products more often.

What products improve eyesight, see.

It is not recommended to treat the disease with folk remedies, since in this case they are ineffective. If you rely only on folk remedies, you can lose precious time, when you could still save the quality of vision.

Complications

It must be remembered that optic nerve atrophy is a serious disease and should not be treated on its own. Improper self-treatment can lead to sad consequences - complications of the disease.

The most serious complication can be complete loss of vision. Ignoring treatment leads to further development of the disease and a steady decrease in visual acuity, as a result of which the patient will no longer be able to lead a former lifestyle. Very often, with atrophy of the optic nerve, the patient receives a disability.

Also read about heterochromia.

Prevention

To avoid the occurrence of optic nerve atrophy, it is necessary to treat diseases in a timely manner, contact an ophthalmologist in time with a decrease in visual acuity, and not expose the body to alcohol and drug intoxication. Only if you treat your health with due attention can you reduce the risk of disease.

Video

Atrophy of the optic nerve is usually called the process of partial (PAN), and in some cases - complete destruction of the 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" of the development of atrophy, these include: tumors, syphilitic lesions, meningitis, brain abscesses, encephalitis, skull injuries, disseminated. In addition, the causes of the development of such an anomaly can be atherosclerosis, hypertension, quinine poisoning, profuse bleeding, beriberi.

Starvation of the tissues of the internal structures of the eye due to obstruction of the central or peripheral artery 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 considered to be an intractable decrease in vision. Such a symptom can manifest itself in various ways, depending on the type of atrophy. The progress of the disease leads to a non-stop decrease in vision due to the death of the optic nerve, which ultimately leads to complete blindness. This process proceeds, as a rule, either rapidly - in a few days, or gradually - over the course of months.

Partial atrophy of the optic nerve in its course always has a stop in the process of visual impairment at some stage, after which vision stabilizes. This makes it possible to isolate progressive and complete atrophy.

Visual disturbances during the course of the disease are of the most diverse nature, including changes in visual fields (as a rule, 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. Such a condition is associated with the appearance of - dark spots in any part of the field of view, any disorder of color perception.

With PAIS, the change in visual fields is not only "tunnel", which is due to the localization of the pathological process. Thus, development in front of the eyes of cattle may indicate a change in the nerve fibers of the central section of the retina or the zone directly close to it. When the nerve fibers of the periphery are affected, a narrowing of the visual fields develops, and when the lesions are deep enough, the disappearance of half of the visual field is observed. These changes may develop in either one or both eyes.

Diagnosis

It is unacceptable to engage in self-diagnosis, and even more so self-treatment with atrophy of the optic nerve, since similar symptoms are also observed in peripheral, in which, at first, lateral vision undergoes a change, with the involvement of the central departments at 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, the establishment of its causes at an early stage is especially important.

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

Diagnosis of optic nerve 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, they must be carried out, which can reveal the characteristic pallor of the optic nerve head and some narrowing of the bottom. Measure intraocular pressure.

Often, to clarify the diagnosis, an x-ray examination is prescribed (craniography with a picture of the Turkish saddle), magnetic resonance or computed tomography of the brain, fluorescein angiographic or electrophysiological research methods, using contrast, when the patency of the retinal vessels is inspected.

Laboratory tests are also needed - a complete blood count, its biochemistry, a test for borreliosis, as well as syphilis.

Video about the latest developments in the treatment of PONS

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 the therapy of those fibers that are not yet completely destroyed and partially retain their vital activity. True, if this moment has already been missed, vision is irrevocably lost.

It is worth remembering that often partial atrophy of the optic nerve is not a separate disease, but develops due to certain pathological processes that develop in the sections of the visual pathway. Therefore, its treatment, as a rule, begins with the elimination of the causes of the pathology. If, by this time, 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 edema 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 long, with a weakly pronounced effect, which is completely absent in advanced cases. Therefore, the success of treatment, of course, depends on how quickly the atrophy is diagnosed.

1. As noted above, the main thing is the treatment of the disease that caused the atrophy, therefore complex therapy is prescribed with various forms of drugs: eye drops, injections (general and local), tablets, physiotherapy. This treatment aims to:
2. Improving blood circulation, feeding the nerve vessels. For this, vasodilators are used (complamin, no-shpu, nicotinic acid, papaverine, dibazol, halidor, eufillin, sermion, trental), as well as anticoagulants (heparin or ticlide);
3. Improving the processes of tissue metabolism 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, eleutorococcus);
4. Relief of inflammatory processes through hormonal drugs (dexamethasone,);
5. Improving the functions of the central nervous system (cerebrolysin, nootropil, phezam, emoxipin, cavinton).

Any drugs must be taken strictly according to the scheme prescribed by the attending physician, after the diagnosis is established. Since, only a specialist is able to choose the optimal treatment, taking into account concomitant diseases.

At the same time, physiotherapeutic procedures and acupuncture can be prescribed; sessions of laser, magnetic, as well as electrical stimulation of the tissues of the optic nerve.

Such treatment must be repeated courses several times a year.

With an obvious drop in vision, a disability group can be assigned.

Blinded due to illness and visually impaired, rehabilitation courses are prescribed, which aim to eliminate or compensate for the limitations of 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?

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

Atrophy of the optic nerve is the complete or partial destruction of its fibers with their replacement by connective tissue.

Causes of optic nerve atrophy

The causes of visual atrophy include heredity and congenital pathology; it can be the result of various eye diseases, pathological processes in the retina and optic nerve (inflammation, dystrophy, trauma, toxic damage, edema, stagnation, various circulatory disorders, compression of the optic nerve, etc.), pathologies of the nervous system or with general diseases.

More often, optic nerve atrophy develops as a result of pathology of the central nervous system (tumors, syphilitic lesions, brain abscesses, encephalitis, meningitis, multiple sclerosis, skull injuries), intoxication, alcohol poisoning with methyl alcohol, etc.

Also, the causes of the development of optic nerve atrophy can be hypertension, atherosclerosis, quinine poisoning, beriberi, starvation, profuse bleeding.

Optic nerve atrophy appears as a result of obstruction of the central and peripheral retinal arteries that feed the optic nerve, and it is also the main symptom of glaucoma.

Symptoms of optic nerve atrophy

Allocate primary and secondary atrophy of the optic nerves, partial and complete, complete and progressive, unilateral and bilateral.

The main symptom of optic nerve atrophy is a decrease in visual acuity that cannot be corrected. Depending on the type of atrophy, this symptom manifests itself in different ways. So, with the progression of atrophy, vision gradually decreases, which can lead to complete atrophy of the optic nerve and, accordingly, to complete loss of vision. This process can take from several days to several months.

With partial atrophy, the process stops at some stage and vision ceases to deteriorate. Thus, they distinguish progressive atrophy of the optic nerves and complete.

Visual impairment during atrophy can be very diverse. This can be a change in the fields of vision (more often a narrowing, when “side vision” disappears), up to the development of “tunnel vision”, when a person looks as if through a tube, i.e. sees objects that are only directly in front of him, while scotomas often appear, i.e. dark spots in any part of the field of view; It could also be a color vision disorder.

The change in visual fields can be not only “tunnel”, it depends on the localization of the pathological process. Thus, the appearance of scotomas (dark spots) right in front of the eyes indicates damage to nerve fibers closer to the central or directly in the central part of the retina, narrowing of the visual fields occurs due to damage to peripheral nerve fibers, with deeper lesions of the optic nerve, half of the field of vision (or temporal , or nasal). These changes can be in one or both eyes.

Examination for suspected optic nerve atrophy

It is unacceptable to engage in self-diagnosis and self-treatment with this pathology, because something similar happens with peripheral cataract, when peripheral vision is first disturbed, and then the central sections are already involved. Also, atrophy of the optic nerves can be confused with amblyopia, in which vision can also be significantly reduced and cannot be corrected. It is worth noting that the above pathology is not as dangerous as optic nerve atrophy. Aatrophy can be not only an independent disease or a consequence of some local pathology in the eye, but also a symptom of a serious and sometimes fatal disease of the nervous system, so it is very important to establish the cause of optic nerve atrophy as early as possible.

If you experience similar symptoms, you should immediately contact an ophthalmologist and neurologist. These two specialists are mainly involved in the treatment of this disease. There is also a separate branch of medicine - neuro-ophthalmology, doctors - neuro-ophthalmologists, who are engaged in the diagnosis and treatment of such a pathology. If necessary, neurosurgeons, therapists, otorhinolaryngologists, infectious disease specialists, oncologists, toxicologists, etc. can also take part in the diagnosis and treatment.

Diagnosis of atrophy of the optic nerve is usually not difficult. It is based on the definition of visual acuity and fields (perimetry), on the study of color perception. The ophthalmologist necessarily conducts ophthalmoscopy, in which it detects blanching of the optic nerve head, narrowing of the fundus vessels and measures intraocular pressure. A change in the contours of the optic disc indicates the primacy or secondary nature of the disease, i.e. if its contours are clear, then most likely the disease developed for no apparent reason, but if the contours are blurred, then this is probably post-inflammatory or post-congestive atrophy.

If necessary, an x-ray examination is performed (craniography with a mandatory image of the Turkish saddle), computed or magnetic resonance imaging of the brain, electrophysiological research methods and fluorescein angiographic methods, in which the patency of the retinal vessels is checked using a special substance administered intravenously.

Laboratory research methods can also be informative: a complete blood count, a biochemical blood test, a test for syphilis or borreliosis.

Treatment of optic nerve atrophy

Treatment of optic nerve atrophy is a very difficult task for physicians. You need to know that destroyed nerve fibers cannot be restored. One can hope for some effect from the treatment only when the functioning of the nerve fibers that are in the process of destruction, which still retain their vital activity, is restored. If you miss this moment, then the vision in the sore eye can be lost forever.

When treating atrophy, it must be borne in mind that this is often not an independent disease, but a consequence of other pathological processes affecting various parts of the visual pathway. Therefore, the treatment of optic nerve atrophy must be combined with the elimination of the cause that caused it. In the case of timely elimination of the cause and if the atrophy has not yet developed, within 2-3 weeks to 1-2 months, the fundus picture normalizes and visual functions are restored.

The treatment is aimed at eliminating edema and inflammation in the optic nerve, at improving its blood circulation and trophism (nutrition), restoring the conductivity of incompletely destroyed nerve fibers.

But it should be noted that the treatment of optic nerve atrophy is lengthy, the effect of it is weak, and sometimes completely absent, especially in advanced cases. Therefore, it should be started as early as possible.

As mentioned above, the main thing is the treatment of the underlying disease, against which complex treatment is carried out directly for atrophy of the optic nerve. To do this, prescribe various forms of drugs: eye drops, injections, both general and local; tablets, electrophoresis. Treatment is aimed at

• improvement of blood circulation in the vessels supplying the nerve - vasodilators (complamin, nicotinic acid, no-shpa, papaverine, dibazol, eufillin, trental, halidor, sermion), anticoagulants (heparin, tiklid);
• to improve metabolic processes in the nerve tissue and stimulate the restoration of altered tissue - biogenic stimulants (aloe extract, peat, vitreous body, etc.), vitamins (ascorutin, B1, B2, B6), enzymes (fibrinolysin, lidase), amino acids (glutamic acid ), immunostimulants (ginseng, eleutorococcus);
• for the resorption of pathological processes and stimulation of metabolism (phosphaden, preductal, pyrogenal); for the relief of the inflammatory process - hormonal drugs (prednisolone, dexamethasone); to improve the functioning of the central nervous system (emoxipin, cerebrolysin, phezam, nootropil, cavinton).

Drugs must be taken as prescribed by the doctor after the diagnosis is established. The doctor will select the optimal treatment, taking into account concomitant diseases. In the absence of concomitant somatic pathology, you can independently take no-shpu, papaverine, vitamin preparations, amino acids, emoxipin, nootropil, phezam.

But self-medication with this serious pathology should not be engaged. Physiotherapy treatment, acupuncture are also used; methods of magnetic, laser and electrical stimulation of the optic nerve have been developed.

The course of treatment is repeated after a few months.

Nutrition for atrophy of the optic nerve should be complete, varied and rich in vitamins. It is necessary to eat as many fresh vegetables and fruits as possible, meat, liver, dairy products, cereals, etc.

With a significant decrease in vision, the issue of assigning a disability group is decided.

The visually impaired and the blind are prescribed a course of rehabilitation aimed at eliminating or compensating for the limitations of life activity that have arisen as a result of loss of vision.

Treatment with folk remedies is dangerous because precious time is lost, when it is still possible to cure atrophy and restore vision. It should be noted that with this disease, folk remedies are ineffective.

Complications of optic nerve atrophy

The diagnosis of optic nerve atrophy is very serious. At the slightest decrease in vision, you should 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 addition, it is very important to identify the cause of the atrophy of the optic nerve, and eliminate it as soon as possible, because this can be fraught not only with loss of vision, but also deadly.

Prevention of optic nerve atrophy

In order to reduce the risk of optic nerve atrophy, it is necessary to promptly treat diseases that lead to atrophy, prevent intoxication, conduct blood transfusions in case of profuse bleeding, and, of course, consult a doctor in a timely manner at the slightest sign of visual impairment.

Ophthalmologist Odnochko E.A.