Optic nerve atrophy: treatment, symptoms, causes of complete or partial damage. Partial optic nerve atrophy (chazn) causes, diagnosis and treatment Treatment of optic nerve atrophy

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 taking a closer look at this disease so that it is possible to identify 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 to deliver nerve impulses to the brain area.

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

Where is the optic nerve located?

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

Optic atrophy is an eye disease in which the optic nerve deteriorates, resulting in decreased vision. With this disease, the fibers of the optic nerve completely or partially die and are replaced by connective tissue. As a result, 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, optic nerve atrophy can be partial or complete. Partial atrophy of the optic nerve differs from complete atrophy by a less pronounced manifestation of the disease and preservation of vision at a certain level.

Vision correction using 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 some pathological process in the patient’s body.

Optic 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 injury, brain tumors, multiple sclerosis, encephalitis, meningitis, arachnoiditis).
Diseases of the cardiovascular system (cerebral atherosclerosis, arterial hypertension, vascular spasm).
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 optic atrophy occurs as a result of genetic diseases (in most cases Leber disease). In this case, the patient has low quality of vision from birth.

Acquired optic atrophy appears as a result of certain diseases in older age.

Symptoms

The main symptoms of partial visual atrophy may be:

Deterioration in the quality of vision and the inability to correct it with traditional correction methods.
Pain when moving the eyeballs.
Change in color perception.
Narrowing of visual fields (up to the manifestation of tunnel syndrome, in which the ability to peripherally view is completely lost).
The appearance of blind spots in the field of vision (scotomas).

Laser vision correction methods can be seen in.

Stages of optic nerve atrophy

Diagnostics

Typically, diagnosing this disease does not cause any particular difficulties. As a rule, the patient notices a significant decrease in vision and consults an ophthalmologist, who makes the correct diagnosis. Identifying the cause of the disease is of great importance.

To identify optic nerve atrophy in a patient, a set of diagnostic methods is performed:

(visual acuity test).
Spheroperimetry (determination of visual fields).
Ophthalmoscopy (detection of pallor of the optic nerve head and narrowing of the fundus vessels).
Tonometry (measurement of intraocular pressure).
Video-ophthalmography (study of the optic nerve relief).
(examination of areas of the affected nerve).
Computed tomography and magnetic resonance imaging (a study of the brain to identify possible causes of optic atrophy).

Read what computer perimetry determines in ophthalmology.

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

Treatment

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

The difference between partial optic nerve atrophy and complete one 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 optic nerve tissue.

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

During the treatment of the underlying disease that caused optic nerve atrophy, complex therapy is carried out. Additionally, during treatment, medications can be used to improve blood supply and nutrition to the optic nerve, improve metabolism, eliminate swelling and inflammation. It would be a good idea to take multivitamins and biostimulants.

The main drugs used are:

Vasodilators. These drugs improve blood circulation and trophism in the tissues of the optic nerve. Among the drugs in this group one can highlight complamin, papaverine, dibazol, no-shpu, halidor, aminophylline, trental, sermion.
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 metabolic stimulants (phosphaden, pyrogenal, preductal).

It is necessary to understand that drug therapy does not treat optic nerve atrophy, but only helps to improve the condition of the nerve fibers. To cure optic nerve atrophy, it is necessary to first cure the underlying disease.

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

The following procedures are used as additional treatment:

Magnetic stimulation. During this procedure, the optic nerve is exposed to a special device that creates an alternating magnetic field. Magnetic stimulation helps 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 blood-ophthalmic 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 of low-power direct current and drugs on the eye tissue. Electrophoresis helps to dilate blood vessels, improve cell metabolism and normalize metabolism.
Oxygen therapy. This method consists of saturating the tissues of the optic nerve with oxygen, which helps improve metabolic processes in them.

During treatment of optic nerve atrophy, it is imperative to maintain a high-quality diet rich in various vitamins and minerals. It is necessary to consume fresh vegetables and fruits, cereals, meat, and dairy products more often.

See what foods improve vision.

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 preserve the quality of your vision.

Complications

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

The most serious complication may 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 his previous lifestyle. Very often, with optic nerve atrophy, the patient becomes disabled.

Prevention

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

Video

Optic atrophy is a disease in which vision decreases, sometimes to the point of complete loss. This occurs when the nerve fibers that carry information about what a person sees from the retina to the visual part of the brain partially or completely die. This pathology can arise due to many reasons, so a person can encounter it at any age.

Important! Timely detection and treatment of the disease, if the death of the nerve is partial, helps stop the loss of visual function and restore it. If the nerve has completely atrophied, then vision will not be restored.

The optic nerve is an afferent nerve fiber that runs from the retina to the occipital visual region of the brain. Thanks to this nerve, information about the picture visible to a person is read from the retina and transmitted to the visual department, where it is already transformed into a familiar image. When atrophy occurs, the nerve fibers begin to die and are replaced by connective tissue, which is similar to scar tissue. In this condition, the functioning of the capillaries supplying the nerve stops.

How is the disease classified?

Depending on the time of occurrence, there are congenital and acquired optic nerve atrophy. According to localization, the pathology can be:

ascending - the layer of nerve fibers located on the retina of the eye is affected, and the lesion itself is sent to the brain;
descending - the visual part of the brain is affected, and the lesion is directed to the disc on the retina.

Depending on the degree of the lesion, atrophy can be:

initial - only some fibers are affected;
partial – the diameter of the nerve is affected;
incomplete – the lesion is widespread, but vision is not completely lost;
complete – the optic nerve dies, leading to complete loss of visual function.

With a unilateral disease, one nerve is damaged, as a result of which one eye begins to see poorly. When the nerves of both eyes are damaged, they speak of bilateral atrophy. According to the stability of visual function, the pathology can be stationary, in which visual acuity falls and then remains at the same level, and progressive, when vision becomes worse.

Why can the optic nerve atrophy?

The causes of optic nerve atrophy are varied. The congenital form of the disease in children occurs due to genetic pathologies such as Leber's disease. In this case, partial atrophy of the optic nerve most often occurs. The acquired form of pathology occurs due to various diseases of a systemic and ophthalmological nature. Nerve death can occur due to:

compression of the vessels supplying the nerve or the nerve itself by a neoplasm in the skull;
myopia;
atherosclerosis, leading to plaques in blood vessels;
thrombosis of nerve vessels;v
inflammation of the vascular walls during syphilis or vasculitis;
disorders of the structure of blood vessels due to diabetes mellitus or increased blood pressure;
eye injury;
intoxication of the body during respiratory viral infections, when consuming large doses of alcohol, drugs or due to excessive smoking.

The ascending form of the disease occurs with eye diseases such as glaucoma and myopia. Causes of descending optic atrophy:

retrobulbar neuritis;
traumatic damage to the place where the optic nerves cross;
neoplasm in the pituitary gland of the brain.

Unilateral disease occurs due to diseases of the eyes or orbits, as well as from the initial stage of cranial diseases. Both eyes can suffer from atrophy at once due to:

intoxications;
syphilis;
neoplasms in the skull;
poor blood circulation in nerve vessels during atherosclerosis, diabetes, hypertension.

What clinical picture does the disease have?

Symptoms of optic atrophy depend on the form of the disease. If this disease occurs, vision cannot be corrected with glasses. The most basic symptom is decreased visual acuity. The second symptom is a change in the fields of visual function. By this sign, the doctor can understand how deep the lesion has occurred.

The patient develops “tunnel vision,” that is, the person sees as he would see if he put a tube to his eye. Peripheral (side) vision is lost and the patient sees only those objects that are directly in front of him. In most cases, such vision is accompanied by scotomas - dark spots in any part of the visual field. Later, color vision disorder begins; the patient first ceases to distinguish between green and then red.

When nerve fibers concentrated as close as possible to the retina or directly in it are damaged, dark spots appear in the center of the visible image. With a deeper lesion, half the image on the side of the nose or temple may disappear, depending on which side the lesion occurred on. With secondary atrophy caused by any ophthalmological disease, the following symptoms occur:

the veins of the eyes dilate;
blood vessels narrow;
the boundaries of the optic nerve area become smoothed;
the retinal disc becomes pale.

Important! If even slight clouding appears in the eye (or both eyes), you should visit an ophthalmologist as soon as possible. Only by detecting the disease in time can you stop it at the stage of partial atrophy and restore vision without allowing complete atrophy.

What are the features of pathology in children

With the congenital form of the disease, it can be determined that the baby’s pupils do not react well to light. As the child grows up, parents may notice that he does not respond to an object brought to him from a certain direction.

Important! A child under two or three years old cannot report that he sees poorly, and older children, whose problem is congenital, may not realize that they can see differently. That is why it is necessary for the child to be examined annually by an ophthalmologist, even if there are no symptoms visible to the parent.

Parents should take their child to the doctor if he rubs his eyes or unconsciously tilts his head to one side while trying to look at something. The forced tilt of the head to some extent compensates for the function of the affected nerve and slightly sharpens vision. The basic clinical picture of optic nerve atrophy in a child is the same as in an adult.

If diagnosis and treatment are carried out in a timely manner, provided that the disease is not genetic, during which the nerve fibers are completely replaced by fibrous tissue during the period of intrauterine development, then the prognosis for the restoration of the optic nerve in children is more favorable than in adult patients.

How is the disease diagnosed?

Diagnosis of optic nerve atrophy is carried out by an ophthalmologist, and first of all includes examination of the fundus and determination of visual fields using computer peripetry. It is also determined which colors the patient can distinguish. Instrumental methods of diagnosis include:

X-ray of the skull;
Magnetic resonance imaging;
angiography of eye vessels;
video-ophthalmological examination;
Ultrasound of the vessels of the head.

Thanks to these studies, it is possible not only to identify the death of the optic nerve, but also to understand why it occurred. You may also need to consult related specialists.

How is optic atrophy treated?

How to treat optic nerve atrophy should be decided by the doctor based on the research conducted. It is immediately worth noting that the treatment of this disease is very difficult, because nerve tissue regenerates very poorly. It is necessary to carry out complex systematic therapy, which should take into account the cause of the pathology, its duration, the age of the patient, and his general condition. If some process occurring inside the skull (for example, a tumor or inflammation) has led to the death of the nerve, then treatment should begin with a neurosurgeon and neuropathologist.

Treatment with medications

With the help of medications, you can increase blood circulation and nerve trophism, as well as stimulate the vital activity of healthy nerve fibers. Drug treatment includes taking:

vasodilators - No-Shpa and Dibazol;
vitamin B;
biogenic stimulants, for example, aloe extract;
drugs that improve microcirculation, such as Eufillin and Trental;
steroidal anti-inflammatory drugs - Hydrocortisone and Dexamethasone;
antibacterial drugs, spruce atrophy has an infectious bacterial pathogenesis.

In addition, physical therapy may be required to stimulate the optic nerve, such as laser stimulation, magnetic therapy, or electrophoresis.

Microsurgical treatment is aimed at eliminating compression of the nerve, as well as increasing the diameter of the vessels that feed it. Conditions can also be created in which new blood vessels can grow. Surgery can only help with partial atrophy; if the nerves die completely, then even through surgery it is impossible to restore visual function.

Treatment with folk remedies

Treatment of optic nerve atrophy with folk remedies is permissible only at the initial stage of the disease, but it is not aimed at improving vision, but at eliminating the root cause of the disease.

Important! Self-medication without prior medical consultation can only aggravate the situation and lead to irreversible consequences.

If the disease is caused by high blood pressure, then plants with antihypertensive properties are used in therapy:

Astragalus wooliflora;
small periwinkle;
hawthorn (flowers and fruits);
chokeberry;
Baikal skullcap (root);
Daurian black cohosh;
grandiflora magnolia (leaves);
swampy dryweed.

Blueberries are good for vision; they contain many vitamins, as well as an anthocyanoside, which has a positive effect on the visual system. For treatment, you need to mix one kilogram of fresh berries with one and a half kilograms of sugar and put it in the refrigerator. This mixture is taken in half a glass for a month. The course must be repeated twice a year, which will be beneficial even with good vision.

If degenerative processes occur in the retina of the eye, especially occurring against the background of low blood pressure, then tinctures for the preparation of which are used will be useful:

Chinese lemongrass leaves;
zamanika roots;
Leuzea;
ginseng;
Eleutherococcus;
sea buckthorn (fruits and pollen).

If incomplete necrosis of the nerves occurs or senile degenerative changes occur in the eyes, then it is necessary to take anti-sclerotic plants:

orange;
cherry;
hawthorn;
cabbage;
corn;
seaweed;
dandelion;
chokeberry;
garlic and onion.

Carrots (contain a lot of carotene) and beets (rich in zinc) have beneficial properties.

What is the prognosis for optic nerve atrophy and its prevention?

When diagnosing and starting therapy at an early stage of development, it is possible to maintain and even slightly increase visual acuity, as well as expand its fields. No treatment can fully restore visual function. If the disease progresses and there is no treatment, it leads to disability due to complete blindness.

In order to prevent the necrosis of nerve fibers, ophthalmological diseases, as well as endocrine, neurological, infectious and rheumatological diseases should be treated in a timely manner. Very important in prevention is the prevention of intoxication damage to the body.

- a process characterized by the gradual death of fibers.

Pathology is often caused by ophthalmological diseases.
The disease is diagnosed when the fibers are damaged. Nerve tissues are located in almost all human organs.

What it is

The optic nerve is a kind of transmission channel. With its help, the image enters the retinal region, then into the brain compartment.

The brain reproduces the signal, turning the description into a clear picture. The optic nerve is connected to many blood vessels from which it receives nutrition.

In a number of processes this relationship is disrupted. The optic nerve dies, which subsequently leads to blindness and disability.

Causes of pathology

During scientific experiments, it was found that 2/3 of cases of optic nerve atrophy were bilateral. The cause is intracranial tumors, edema and disorders of the vascular system, especially in patients aged 42 - 45 years.

The causes of the disease are:

Nerve damage. These include: chronic glaucoma, neuritis, neoplasms.
Neuropathy (ischemic), chronic neuritis, edema is a secondary pathology.
Hereditary neuropathy (Leber).
Neuropathy (toxic). The disease is caused by methanol. This component is found in surrogate alcoholic drinks and medications (Disulfiram, Ethambutol).

The causes of the disease include: retinal damage, TAY-SAXS pathology, syphilis.

The development of atrophy in children is influenced by a congenital anomaly, a negative hereditary factor, and a malnutrition of the optic nerve. Pathology entails disability.

Main classification of the disease

Atrophy of the optic nerve is determined by pathological and ophthalmoscopic signs.

Acquired and congenital form

The acquired form is primary or secondary in nature. Caused by the influence of etiological factors. The process occurs as a result of: inflammation, glaucoma, myopia, and metabolic disorders in the body.

Congenital form: occurs against the background of genetic pathology. There are 6 types of hereditary atrophy: infantile (from birth to 3 years), dominant (juvenile blindness from 3 to 7 years), opto-oto-diabetic (from 2 to 22 years), Beer syndrome (complicated form, appears from 1 year) , increasing (from an early age, gradually progressing), Leicester's disease (hereditary), occurs at the age of 15 - 35 years.

Primary and secondary atrophy

The primary form is localized in a healthy eyeball. Occurs when microcirculation and nutrition of nerve fibers are disrupted.

The occurrence of secondary atrophy is caused by various eye pathologies.

Descending and ascending form

Descending atrophy is characterized by an inflammatory process in the proximal zone of the axon. Retinal disc damage is observed.

In the ascending form, the retina is initially affected. Gradually, the destructive process is directed to the brain. The rate of degeneration will depend on the thickness of the axons.

Partial and full degree

Diagnosing the extent of damage:

initial (damage to some fibers);
partial (diameter damaged);
incomplete (the disease progresses, but vision is not completely lost);
complete (loss of visual functions in full).

There is unilateral and bilateral atrophy. In the first case, damage to the innervation of one eye is observed, in the second - two.

Localization and intensity of optic disc pathology

Visual acuity is affected by the localization and intensity of the atrophic process:

Modification of the field of view. The disorder is determined by topical diagnostics. The process is influenced by localization, not intensity. Damage to the papillomacular bundle provokes the occurrence of a central scotoma. Damaged optic fiber contributes to a narrowing of the peripheral limits of the visual field.
Violation of color schemes. This symptomatology is clearly expressed in the descending form of the optic disc. The course of the process is determined by previous neuritis or swelling. In the first stages of the disease, the visible outlines of green and red hues are lost.
Pale color of the optic disc. Additional examination using campimetry is required. It is necessary to collect information about the patient's initial visual acuity. In some cases, visual sharpness exceeds one.

If unilateral atrophy is diagnosed, repeated examination will be required to avoid damage to the second eye (bilateral atrophy).

Symptoms of eye disease

The main symptoms of the onset of atrophy are expressed by progressive deterioration of vision in one or both eyes. Vision cannot be treated or improved with ordinary correction methods.

Symptoms are expressed:

loss of lateral visibility (fields narrow);
the appearance of tunnel vision;
the formation of dark spots;
decreased pupillary reflex to light rays.

When the optic nerve is damaged, optic neuropathy develops, which leads to partial or complete blindness.

Correct medical diagnosis

An ophthalmological examination determines the presence and extent of the disease. The patient should consult a neurosurgeon and neurologist.

To establish a correct diagnosis you need to go through:

ophthalmoscopy (examination of the fundus of the eye);
visometry (the degree of damage to visual perception is determined);
perimetry (visual fields are examined);
computer perimetry (the affected area is determined);
evaluation score of color readings (the location of the fiber is determined);
video - ophthalmography (the nature of the pathology is revealed);
craniography (an X-ray of the skull is taken).

Additional examinations may be prescribed, which include CT scanning, magnetic resonance imaging, and laser Doppler ultrasound.

Treatment of the disease - preventing disability

After diagnosis, the specialist prescribes intensive therapy. The doctor’s task is to eliminate the causes of the pathology, stop the progression of the atrophic process, and prevent the patient from becoming completely blind and disabled.

Effective drug treatment of the patient

It is impossible to restore dead nerve fibers. Therefore, therapeutic measures are aimed at stopping inflammatory processes with the help of drugs.

This ophthalmological disease is treated:

Vasodilators. The drugs stimulate blood circulation. The most effective: No-shpa, Dibazol, Papaverine.
Anticoagulants. The action of the drugs is aimed at preventing blood clotting and the formation of thrombosis. The specialist prescribes: Heparin, Tiklid.
Biogenic stimulants. The metabolic process in nerve tissue structures is enhanced. This group of products includes: Peat, Aloe extract.
Vitamin complex. Vitamins are a catalyst for biochemical reactions that occur in the eye tissue structures. For the treatment of pathology, the following is prescribed: Ascorutin, B1, B6, B12.
Immunostimulants. Promote cell regeneration, suppress inflammatory processes (in case of infection). The most effective: Ginseng, Eleutherococcus.
Hormonal medications. Inflammatory symptoms are relieved. Prescribed: Dexamethasone, Prednisolone individually (in the absence of contraindications).

The patient receives certain results from acupuncture and physiotherapy (ultrasound, electrophoresis).

Surgical intervention - main types of operations

The surgical procedure is indicated for patients with a poor prognosis: optic nerve atrophy with the possibility of blindness.

Types of operations:

Vasoconstructive. The temporal or carotid arteries are ligated, and the blood flow is redistributed. The blood supply to the orbital arteries improves.
Extrascleral. Own tissue is transplanted. An antiseptic effect is created on the affected areas, a healing effect is caused, and blood supply is stimulated.
Decompression. The scleral or bony canaliculus of the optic nerve is dissected. There is an outflow of venous blood. The pressure on the beam section is reduced. Result: the functional abilities of the optic nerve improve.

After drug or surgical treatment, it would be advisable to use alternative medicine.

Traditional medicines stimulate metabolism and increase blood circulation. The use of folk remedies is allowed after consultation with the attending physician (ophthalmologist).

Fighting illness in children

Therapy in children is aimed at saving nerve fibers and stopping the process. Without adequate treatment, the child will become completely blind and disabled.

Despite measures taken at the beginning of treatment, optic atrophy often progresses and develops. In some cases, the duration of therapy will be 1 to 2 months. For advanced forms of atrophy, treatment lasts from 5 to 10 months.

After the examination, the doctor prescribes for the child:

magnetic stimulation;
electrical stimulation;
vasodilators;
biostimulating medications;
vitamin cocktail;
enzymes.

If taking medications does not bring results and the disease continues to progress, a course of laser therapy or surgical measures is prescribed.

Tabetic nerve atrophy

Tabes is a disease of the nervous system due to infection with syphilis. If timely treatment is not applied, the disease progresses, causing ocular trophic disorders.

Tabes optic atrophy is the only manifestation of tabes (an early symptom of neurosyphilis). The tabetic form of atrophy is characterized by bilateral vision loss.

A sign of the disease is reflex immobility of the pupils. The optic nerve papilla becomes discolored and becomes gray-white.

There is a sharp decline in vision, the pathology is difficult to treat. Therapy is prescribed by a venereologist and neurologist (treatment of the primary infection is mandatory). Initially, medications and vitamins are prescribed that stimulate metabolic processes in tissue structures.

Prescribed internally:

vitamin A;
ascorbic acid;
a nicotinic acid;
calcium (pangamate);
riboflavin.

After three days, intramuscular injections are prescribed: vitamin B, B6, B12. The drugs are combined with aloe or vitreous extract. Treatment is carried out under the strict supervision of a specialist in a medical institution.

Atrophy due to methyl alcohol poisoning

Methyl alcohol and technical alcohol mixtures can cause serious damage to vision. Pathology sometimes occurs due to methyl alcohol poisoning.

The first sign of poisoning is characterized by: migraine, dizziness, nausea, vomiting, diarrhea. The pupil becomes dilated, the clarity of vision is impaired, and light reflections cannot be distinguished. There is a sharp decrease in vision.

Therapy for this form of atrophy consists of using: alkalizing medications, calcium, B vitamins, ascorbic acid.

In patients diagnosed with methyl arthophy, the prognosis for recovery is pessimistic. Vision restoration is observed in only 15% of patients.

Optic nerve atrophy is damage to nerve fibers. When the process is prolonged, the neurons die, which leads to loss of vision.

Diagnosis of atrophy

When examining patients with optic nerve atrophy, it is necessary to find out the presence of concomitant diseases, the fact of taking medications and contact with chemicals, the presence of bad habits, as well as complaints indicating possible intracranial lesions.

During a physical examination, the ophthalmologist determines the absence or presence of exophthalmos, examines the mobility of the eyeballs, checks the reaction of the pupils to light, and the corneal reflex. Visual acuity testing, perimetry, and color vision testing are required.

Basic information about the presence and degree of optic nerve atrophy is obtained using ophthalmoscopy. Depending on the cause and form of optic neuropathy, the ophthalmoscopic picture will differ, but there are typical characteristics found in various types of optic atrophy.

These include: pallor of the optic disc of varying degrees and prevalence, changes in its contours and color (from grayish to waxy), excavation of the disc surface, a decrease in the number of small vessels on the disc (Kestenbaum’s symptom), narrowing of the caliber of the retinal arteries, changes in the veins, etc. Condition The optic disc is clarified using tomography (optical coherence, laser scanning).

An electrophysiological study (EPS) reveals a decrease in lability and an increase in the threshold sensitivity of the optic nerve. In the glaucomatous form of optic nerve atrophy, tonometry is used to determine an increase in intraocular pressure.

Pathology of the orbit is detected using plain radiography of the orbit. Examination of retinal vessels is carried out using fluorescein angiography. The study of blood flow in the orbital and supratrochlear arteries, and the intracranial portion of the internal carotid artery is performed using Doppler ultrasound.

If necessary, the ophthalmological examination is supplemented by a study of the neurological status, including consultation with a neurologist, radiography of the skull and sella, CT or MRI of the brain. If a patient has a brain mass or intracranial hypertension, consultation with a neurosurgeon is necessary.

In the case of a pathogenetic connection between optic nerve atrophy and systemic vasculitis, consultation with a rheumatologist is indicated. The presence of orbital tumors dictates the need to examine the patient by an ophthalmic-oncologist. Therapeutic tactics for occlusive lesions of the arteries (orbital, internal carotid) are determined by an ophthalmologist or vascular surgeon.

For optic nerve atrophy caused by infectious pathology, laboratory tests are informative: ELISA and PCR diagnostics.

The differential diagnosis of optic atrophy should be made with peripheral cataracts and amblyopia.

Forecast

The degree of vision loss in a patient depends on two factors - the severity of damage to the nerve trunk and the time of treatment. If the pathological process has affected only a part of the neurocytes, in some cases it is possible to almost completely restore the functions of the eye, with adequate therapy.

Unfortunately, with the atrophy of all nerve cells and the cessation of impulse transmission, there is a high probability of the patient developing blindness. The solution in this case may be surgical restoration of tissue nutrition, but such treatment does not guarantee the restoration of vision.

Physiotherapy

There are two physiotherapeutic techniques, whose positive effects are confirmed by scientific research:

Pulsed magnetic therapy (MPT) - this method is not aimed at restoring cells, but at improving their functioning. Thanks to the targeted influence of magnetic fields, the contents of neurons are “condensed”, which is why the generation and transmission of impulses to the brain is faster.
Bioresonance therapy (BT) - its mechanism of action is associated with improving metabolic processes in damaged tissues and normalizing blood flow through microscopic vessels (capillaries).

They are very specific and are used only in large regional or private ophthalmology centers, due to the need for expensive equipment. As a rule, for most patients these technologies are paid, so BMI and BT are used quite rarely.

Prevention

Optic atrophy is a serious disease.

To prevent it, you need to follow some rules:

consultation with a specialist if there is the slightest doubt about the patient’s visual acuity;
prevention of various types of intoxication;
promptly treat infectious diseases;
do not abuse alcohol;
monitor blood pressure;
prevent eye and traumatic brain injuries;
repeated blood transfusion for profuse bleeding.

Timely diagnosis and treatment can restore vision in some cases, and slow or stop the progression of atrophy in others.

Complications

In order to prevent the occurrence of pathologies of the optic nerve, it is necessary to carefully monitor your health and undergo regular examinations by specialists (rheumatologist, endocrinologist, neurologist, ophthalmologist). At the first signs of vision deterioration, you should consult an ophthalmologist.

Disability

Disability group I is established with IV degree of impairment of the functions of the visual analyzer - significantly pronounced dysfunction (absolute or practical blindness) and a decrease in one of the main categories of life activity to degree 3 with the need for social protection.

Basic criteria of IV degree of dysfunction of the visual analyzer.

blindness (vision equal to 0) in both eyes;
visual acuity with correction of the better eye is not higher than 0.04;
bilateral concentric narrowing of the boundaries of the visual field to 10-0° from the point of fixation, regardless of the state of central visual acuity.

Disability group II is established in case of III degree of dysfunction of the visual analyzer - pronounced dysfunction (high degree of low vision), and a decrease in one of the main categories of life activity to 2 degree with the need for social protection.

The main criteria for severe visual impairment are:

visual acuity of the better eye from 0.05 to 0.1;
bilateral concentric narrowing of the boundaries of the visual field to 10-20° from the point of fixation, when work activity is possible only in specially created conditions.

Disability group III is established for degree II - moderate dysfunction (moderate low vision) and a decrease in one of the main categories of life activity to degree 2 with the need for social protection.

The main criteria for moderate visual impairment are:

decrease in visual acuity of the better seeing eye from 0.1 to 0.3;
unilateral concentric narrowing of the boundaries of the visual field from the point of fixation of less than 40°, but more than 20°;

In addition, when making a decision on the disability group, all diseases that the patient has are taken into account.

Optic nerve atrophy 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 a consequence of various eye diseases, pathological processes in the retina and optic nerve (inflammation, dystrophy, trauma, toxic damage, swelling, congestion, various circulatory disorders, compression of the optic nerve, etc.), pathology of the nervous system or 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, vitamin deficiency, fasting, and profuse bleeding.

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

Symptoms of optic atrophy

There are 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 differently. Thus, as atrophy progresses, vision gradually decreases, which can lead to complete atrophy of the optic nerve and, accordingly, to complete loss of vision. This process can take place from several days to several months.

With partial atrophy, the process stops at some stage and vision stops deteriorating. Thus, progressive atrophy of the optic nerves is distinguished and complete.

Visual impairment due to atrophy can be very diverse. This can be a change in visual fields (usually narrowing, when “lateral 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, and scotomas often appear, i.e. dark spots in any part of the visual field; It could also be a color vision disorder.

Changes 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 before 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 visual field (or temporal , or nasal). These changes can occur in one or both eyes.

Examination for suspected optic nerve atrophy

It is unacceptable to engage in self-diagnosis and self-medication for this pathology, because something similar happens with peripheral cataracts, when lateral vision is first impaired, and then the central parts are involved. Also, optic atrophy 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 similar symptoms occur, you should immediately contact an ophthalmologist and neurologist. These two specialists are primarily 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 pathologies. If necessary, neurosurgeons, therapists, otorhinolaryngologists, infectious disease specialists, oncologists, toxicologists, etc. can also take part in diagnosis and treatment.

Diagnosis of optic atrophy is usually not difficult. It is based on the determination of visual acuity and fields (perimetry), on the study of color perception. An ophthalmologist must perform an ophthalmoscopy, during which he detects blanching of the optic nerve head, narrowing of the vessels of the fundus and measures intraocular pressure. A change in the contours of the optic nerve head indicates the primary or secondary nature of the disease, i.e. if its contours are clear, then most likely the disease has developed for no apparent reason, but if the contours are blurred, then perhaps it is post-inflammatory or post-stagnant atrophy.

If necessary, an X-ray examination is carried out (craniography with a mandatory image of the sella region), computed tomography 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 general blood test, a biochemical blood test, a test for syphilis or borelliosis.

Treatment of optic atrophy

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

When treating atrophy, it is necessary to keep 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, treatment of optic nerve atrophy must be combined with elimination of the cause that caused it. If the cause is eliminated in a timely manner and if atrophy has not yet developed, normalization of the fundus picture and restoration of visual functions occurs within 2-3 weeks to 1-2 months.

Treatment is aimed at eliminating edema and inflammation in the optic nerve, improving its blood circulation and trophism (nutrition), restoring the conductivity of not completely destroyed nerve fibers.

But it should be noted that the treatment of optic nerve atrophy is long-term, its effect 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 the background of which complex treatment of optic nerve atrophy is carried out. For this, various forms of drugs are prescribed: 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-spa, papaverine, dibazol, aminophylline, trental, halidor, sermion), anticoagulants (heparin, ticlid);
to improve metabolic processes in nerve tissue and stimulate the restoration of altered tissue - biogenic stimulants (aloe extract, peat, vitreous, etc.), vitamins (ascorutin, B1, B2, B6), enzymes (fibrinolysin, lidase), amino acids (glutamic acid ), immunostimulants (ginseng, eleuthorococcus);
to resolve pathological processes and stimulate metabolism (phosphaden, preductal, pyrogenal); to relieve the inflammatory process - hormonal drugs (prednisolone, dexamethasone); to improve the functioning of the central nervous system (emoxipin, Cerebrolysin, Fezam, nootropil, Cavinton).

Medicines must be taken as prescribed by a doctor after diagnosis. The doctor will select the optimal treatment, taking into account concomitant diseases. In the absence of concomitant somatic pathology, you can independently take no-shpa, papaverine, vitamin preparations, amino acids, emoxypine, nootropil, fesam.

But you should not self-medicate for this serious pathology. Physiotherapeutic treatment and 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 several months.

Nutrition for optic nerve atrophy should be complete, varied and rich in vitamins. You need to eat as much fresh vegetables and fruits as possible, meat, liver, dairy products, cereals, etc.

If vision is significantly reduced, 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 in life that have arisen as a result of vision loss.

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 for this disease, folk remedies are ineffective.

Complications of optic atrophy

The diagnosis of optic atrophy is very serious. At the slightest decrease in vision, you should immediately consult a doctor so as not to miss your chance of recovery. Without treatment and as the disease progresses, vision may disappear completely, and it will be impossible to restore it. In addition, it is very important to identify the cause of optic nerve atrophy and eliminate it as early as possible, because this can not only lead to loss of vision, but can also be fatal.

Prevention of optic 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, promptly consult a doctor at the slightest sign of vision deterioration.

Ophthalmologist E.A. Odnoochko

The second pair of cranial nerves is the most important element of the visual system, because through it the connection between the retina and the brain occurs. Although other structures continue to function correctly, any deformation of the nervous tissue affects the properties of vision. Optic nerve atrophy cannot be cured without leaving a trace; nerve fibers cannot be restored to their original state, so it is better to carry out prevention in a timely manner.

Basic information on the disease

Optic nerve atrophy or optic neuropathy is a severe process of destruction of axons (nerve tissue fibers). Extensive atrophy thins the nerve column, healthy tissue is replaced by glial tissue, and small vessels (capillaries) are blocked. Each of the processes causes certain symptoms: visual acuity decreases, various defects appear in the visual field, and the shade of the optic nerve head (OND) changes. All pathologies of the optic nerves account for 2% of the statistics of eye diseases. The main danger of optical neuropathy is absolute blindness, which occurs in 20-25% of people with this diagnosis.

Optic neuropathy does not develop on its own; it is always a consequence of other diseases, so a person with atrophy is examined by different specialists. Typically, optic nerve atrophy is a complication of a missed ophthalmological disease (inflammation in the structures of the eyeball, swelling, compression, damage to the vascular or nervous network).

Causes of Optic Neuropathy

Despite the many causes of optic nerve atrophy known to medicine, in 20% of cases they remain unclear. Usually these are ophthalmological pathologies, central nervous system diseases, autoimmune disorders, infections, injuries, intoxications. Congenital forms of ADN are often diagnosed together with cranial defects (acrocephaly, microcephaly, macrocephaly) and hereditary syndromes.

Causes of optic nerve atrophy from the visual system:

neuritis;
arterial obstruction;
myopia;
retinitis;
oncological lesion of the orbit;
unstable eye pressure;
local vasculitis.

Injury to nerve fibers can occur during a traumatic brain injury or even the mildest injury to the facial skeleton. Sometimes optic neuropathy is associated with the growth of meningioma, glioma, neuroma, neurofibroma and similar formations in the thickness of the brain. Optical disturbances are possible with osteosarcoma and sarcoidosis.

Causes from the central nervous system:

neoplasms in the pituitary gland or cranial fossa;
compression of chiasmata;
multiple sclerosis.

Atrophic processes in the second pair of cranial nerves often develop as a result of purulent-inflammatory conditions. The main danger is brain abscesses, inflammation of its membranes.

Systemic risk factors

diabetes;
atherosclerosis;
anemia;
avitaminosis;
hypertension;
antiphospholipid syndrome;
Wegener's granulomatosis;
systemic lupus erythematosus;
giant cell arteritis;
multisystem vasculitis (Behcet's disease);
nonspecific aortoarteritis (Takayasu disease).

Read also: Danger and prognosis of the optic nerve.

Significant nerve damage is diagnosed after prolonged fasting, severe poisoning, or massive blood loss. Alcohol and its surrogates, nicotine, chloroform and some groups of medications have a negative effect on the structures of the eyeball.

Optic nerve atrophy in a child

Half of all cases of optic neuropathy in children are caused by inflammatory infections of the central nervous system, brain tumors, and hydrocephalus. Less commonly, the state of destruction is caused by deformation of the skull, cerebral anomalies, infections (mainly “children’s”), and metabolic disorders. Particular attention should be paid to congenital forms of childhood atrophy. They indicate that the baby has brain diseases that arose during prenatal development.

Classification of optical neuropathy

All forms of optic nerve atrophy are hereditary (congenital) and acquired. Congenital diseases are divided according to the type of inheritance; they often indicate the presence of genetic abnormalities and hereditary syndromes that require in-depth diagnosis.

Hereditary forms of ADS

Autosomal dominant (juvenile). Predisposition to nerve destruction is transmitted in a heterogeneous manner. The disease is usually detected in children under 15 years of age; it is recognized as the most common, but weakest form of atrophy. It is always bilateral, although sometimes the symptoms appear asymmetrically. Early signs are detected by 2-3 years, and functional disorders only at 6-20 years. Possible combination with deafness, myopathy, ophthalmoplegia and distance.
Autosomal recessive (infantile). This type of ADN is diagnosed less frequently, but much earlier: immediately after birth or during the first three years of life. The infantile form is bilateral in nature and is often detected in Kenny-Coffey syndrome, Rosenberg-Chattorian, Jensen or Wolfram disease.
Mitochondrial (Leber's atrophy). Mitochondrial optic atrophy is the result of a mutation in mitochondrial DNA. This form is considered a symptom of Leber's disease; it occurs suddenly and resembles external neuritis in the acute phase. Most patients are men 13-28 years old.

Forms of acquired atrophy

primary (squeezing of neurons in the peripheral layers, the optic disc does not change, the boundaries have a clear appearance);
secondary (swelling and enlargement of the optic disc, unclear boundaries, replacement of axons by neuroglia is quite pronounced);
glaucomatous (destruction of the cribriform plate of the sclera due to surges in local pressure).

Destruction can be ascending, when the axons of the cranial nerves are affected, and descending, involving the nerve tissue of the retina. According to symptoms, they distinguish between unilateral and bilateral ADN, according to the degree of progression - stationary (temporarily stable) and in constant development.

Types of atrophy according to the color of the optic disc:

initial (slight blanching);
incomplete (noticeable blanching of one segment of the optic disc);
complete (change in shade over the entire area of the optic disc, severe thinning of the nerve pillar, narrowing of the capillaries).

Symptoms of optic atrophy

The degree and nature of optical disturbances directly depends on which nerve segment is affected. Visual acuity can decrease critically very quickly. Complete destruction ends in absolute blindness, blanching of the optic disc with white or gray spots, and narrowing of the capillaries in the fundus. With incomplete ONH, vision stabilizes at a certain time and no longer deteriorates, and the pallor of the ONH is not so pronounced.

If the fibers of the papillomacular bundle are affected, the deterioration in vision will be significant, and the examination will show a pale temporal zone of the optic disc. In this case, optical disorders cannot be corrected with glasses or even contact lenses. Damage to the lateral zones of the nerve does not always affect vision, which complicates diagnosis and worsens the prognosis.

ADN is characterized by various visual field defects. The following symptoms allow one to suspect optic neuropathy: concentric narrowing, effect, weak pupil reaction. In many patients, the perception of colors is distorted, although more often this symptom develops when axons die after neuritis. Often changes affect the green-red part of the spectrum, but its blue-yellow components can also be distorted.

Diagnosis of optic nerve atrophy

The expressive clinical picture, physiological changes and functional disorders greatly simplify the diagnosis of ADN. Difficulties may arise when actual vision does not match the degree of destruction. To make an accurate diagnosis, the ophthalmologist must study the patient’s medical history, establish or deny the fact of taking certain medications, contact with chemical compounds, injuries, and bad habits. Differential diagnosis is carried out for peripheral lens opacification and amblyopia.

Ophthalmoscopy

Standard ophthalmoscopy allows one to establish the presence of ADN and accurately determine the extent of its spread. This procedure is available in many regular clinics and does not cost much. The results of the study may vary, but some signs are detected in any form of neuropathy: changes in the shade and contour of the optic disc, a decrease in the number of vessels, narrowing of the arteries, and various venous defects.

Ophthalmoscopic picture of optical neuropathy:

Primary: clear disc boundaries, optic disc sizes are normal or reduced, saucer-shaped excavation is present.
Secondary: grayish tint, blurred disc borders, enlarged optic disc, no physiological excavation, peripapillary reflex to light sources.

Coherence tomography

Optical coherence or laser scanning tomography allows us to study the nerve disc in more detail. Additionally, the degree of mobility of the eyeballs is assessed, the reaction of the pupils and the corneal reflex are checked, they are carried out with tables, visual field defects are examined, color vision is checked, and eye pressure is measured. Visually, the ophthalmologist determines the presence.

Plain radiography of the orbit allows you to identify pathologies of the orbit. Fluorescein angiography shows dysfunction of the vasculature. To study local blood circulation, Doppler ultrasound is used. If atrophy is due to infection, laboratory tests such as enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR) are performed.

Electrophysiological tests play a key role in confirming the diagnosis. Optic nerve atrophy changes the threshold sensitivity and lability of the nervous tissue. The rapid progression of the disease increases retino-cortical and cortical time.

The level of reduction depends on the location of the neuropathy:

when the papillomacular bundle is destroyed, sensitivity remains at a normal level;
damage to the periphery causes a sharp increase in sensitivity;
atrophy of the axial fascicle does not change sensitivity, but sharply reduces lability.

If necessary, check the neurological status (x-ray of the skull, CT or MRI of the brain). When a patient is diagnosed with a brain tumor or unstable intracranial pressure, a consultation with an experienced neurosurgeon is prescribed. In case of orbital tumors, it is necessary to include an ophthalmic oncologist in the course. If destruction is associated with systemic vasculitis, you need to contact a rheumatologist. Pathologies of the arteries are dealt with by an ophthalmologist or vascular surgeon.

How is optic atrophy treated?

The treatment regimen for each patient with optic neuropathy is always individual. The doctor needs to get all the information about the disease in order to create an effective plan. People with atrophy require immediate hospitalization, while others are able to maintain outpatient treatment. The need for surgery depends on the causes of ASD and symptoms. Any therapy will be ineffective if vision weakens to 0.01 units or below.

It is necessary to begin treatment of optic nerve atrophy by identifying and eliminating (or stopping) the root cause. If cranial nerve damage is caused by intracranial tumor growth, an aneurysm, or unstable cranial pressure, neurosurgery must be performed. Endocrine factors influence hormonal levels. Post-traumatic compression is corrected surgically by removing foreign bodies, removing chemicals, or limiting hematomas.

Conservative therapy for optic neuropathy is primarily aimed at inhibiting atrophic changes, as well as preserving and restoring vision. Drugs are indicated to expand the vasculature and small vessels, reducing capillary spasm and accelerating blood flow through the arteries. This allows all layers of the optic nerve to be supplied with sufficient nutrients and oxygen.

Vascular therapy for ADN

intravenously 1 ml of nicotinic acid 1%, glucose for 10-15 days (or orally 0.05 g three times a day after meals);
Nikoshpan tablet three times a day;
intramuscularly 1-2 ml No-shpa 2% (or 0.04 g orally);
intramuscularly 1-2 ml of Dibazol 0.5-1% daily (or orally 0.02 g);
0.25 g of Nihexin three times a day;
subcutaneously 0.2-0.5-1 ml of sodium nitrate of increasing concentration 2-10% in a course of 30 injections (increase every three injections).

Decongestants are needed to reduce swelling, which helps reduce compression of the nerve and blood vessels. Anticoagulants are used to prevent thrombosis; the vasodilator and anti-inflammatory Heparin is recognized as the best. It is also possible to prescribe antiplatelet agents (prevention of thrombosis), neuroprotectors (protection of nerve cells), glucocorticosteroids (combat inflammatory processes).

Conservative treatment of ADN

To reduce inflammation in the nervous tissue and relieve swelling, dexamethasone solution is prescribed in the eye, intravenous glucose and calcium chloride, and intramuscular diuretics (Furosemide).
Strychnine nitrate solution 0.1% in a course of 20-25 subcutaneous injections.
Parabulbar or retrobulbar injections of Pentoxifylline, Atropine, xanthinol nicotinate. These drugs help speed up blood flow and improve trophism of nervous tissue.
Biogenic stimulants (FIBS, aloe preparations) in a course of 30 injections.
Nicotinic acid, sodium iodide 10% or Eufillin intravenously.
Vitamins orally or intramuscularly (B1, B2, B6, B12).
Antioxidants (glutamic acid).
Orally Cinnarizine, Riboxin, Piracetam, ATP.
Instillation of Pilocarpine to reduce eye pressure.
Nootropic drugs (Lipocerebrin).
Drugs with antikinin effect (Prodectin, Parmidin) for symptoms of atherosclerosis.

In addition to medications, physical therapy is prescribed. Oxygen therapy (use of oxygen) and blood transfusion (urgent blood transfusion) are effective for ADN. During the recovery process, laser and magnetic procedures are prescribed; electrical stimulation and electrophoresis (administration of drugs using electric current) are effective. If there are no contraindications, acupuncture (use of needles on active points of the body) is possible.

Surgical treatment of optic neuropathy

One of the methods of surgical treatment of the optic nerves is hemodynamic correction. The procedure can be performed under local anesthesia: a collagen sponge is placed in the sub-Tenon's space, which stimulates aseptic inflammation and dilates blood vessels. In this way, it is possible to provoke the growth of connective tissue and new vascular network. The sponge dissolves on its own after two months, but the effect lasts for a long time. The operation can be performed repeatedly, but at intervals of several months.

New branches in the vascular network help improve blood supply to nerve tissue, which stops atrophic changes. Correction of blood flow allows you to restore vision by 60% and eliminate up to 75% of visual field defects if you go to the clinic in a timely manner. If the patient has severe concomitant disorders or atrophy has developed to a late stage, even hemodynamic correction will be ineffective.

For partial atrophy of the optic nerve, the use of a collagen implant is practiced. It is impregnated with antioxidants or drugs to dilate capillaries, and then injected into the eyeball without stitches. This method is effective only when eye pressure is stable. The operation is contraindicated in patients over 75 years of age, with diabetes mellitus, severe somatic disorders and inflammation, and vision less than 0.02 diopters.

Prognosis for optic atrophy

To prevent AD, it is necessary to regularly check the condition of those organs that regulate the functioning of the visual system (central nervous system, endocrine glands, joints, connective tissue). In severe cases of infection or intoxication, as well as severe bleeding, urgent symptomatic treatment must be carried out.

It is impossible to completely restore your vision after neuropathy even in the best clinic. A case is considered successful when the patient’s condition has stabilized, ASD does not progress for a long time, and vision has been partially restored. Many people have permanently reduced visual acuity and also have defects in lateral vision.

Some forms of atrophy continually progress even with adequate treatment. The ophthalmologist’s task is to slow down atrophic and other negative processes. Having stabilized the symptoms, it is necessary to constantly prevent ischemia and neurodegeneration. To do this, long-term maintenance therapy is prescribed, which helps improve the blood lipid profile and prevent the formation of blood clots.

The course of treatment for optic nerve atrophy must be repeated regularly. It is very important to eliminate all factors that can affect the optic nerve axons. A patient with optic neuropathy should regularly visit specialists as indicated. It is necessary to constantly prevent complications and improve lifestyle. Refusal of therapy for optical neuropathy inevitably leads to disability due to total death of nerves and irreversible blindness.

Any changes in the layers of the optic nerve negatively affect a person's ability to see. Therefore, it is necessary to undergo timely examinations for people with a predisposition and treat all diseases that contribute to optic nerve atrophy. Therapy will not help restore vision to 100% when optic neuropathy has already developed enough.