Optic nerve atrophy refers to any disease that causes lesions in the retinal ganglion cells and their axons, resulting in thinning of the optic nerve, a common term in pathology that generally occurs in the axonal degeneration of the ganglion cells between the retina and the lateral geniculate body.
I. Diagnosis
The diagnosis cannot be made on the basis of ocular grayness or pallor of the optic disc and must be made in conjunction with a visual function test. Since the disease can have multiple causes, an etiologic diagnosis must be made simultaneously whenever possible. First of all, the possibility of intracranial occupying lesions should be excluded, supplemented by cranial X-ray and other examinations, which can generally be included in the routine, and other cranial CT and MRI are also selectively applied.
Etiology
It can be caused by a variety of reasons, commonly including ischemia, inflammation, compression, trauma and demyelinating diseases as follows.
1, intracranial hypertension causing secondary optic nerve atrophy.
2, intracranial inflammation, mostly seen in tuberculous meningitis or optic cross arachnoiditis.
3, retinal lesions.
(1) vascular, blockage of the central retinal artery or vein, arteriosclerosis of the optic nerve itself, disorders of normal nutrient vessels, hemorrhage (digestive tract and uterus, etc.).
(2) Inflammatory.
(3) post-glaucoma.
(4) Retinitis pigmentosa.
(5) Refsum’s disease.
(6) Blackmon’s familial dementia.
4. Optic neuritis and optic neuropathy.
(1) Vascular, such as ischemic optic neuropathy.
(2) Demyelinating diseases.
(3) Vitamin deficiencies.
(4) Poisoning due to lead or other metal types, etc.
(5) Herpes zoster.
(6) Syphilitic.
5, tumors due to compression, including meningioma, craniopharyngioma, pituitary adenoma, aneurysm (anterior communicating artery aneurysm) skeletal diseases, including Paget’s disease, deformational osteitis, cranial stenosis and other orbital tumors.
6, trauma
7, metabolic diseases, such as diabetes mellitus, gangliosidosis, etc.
8, hereditary diseases Leber disease, cerebellar ataxia, peripheral neuropathy such as Chareot-Marie-Tooth disease.
9.Dystrophic optic atrophy.
10.Miscellaneous
In children its causes are more complex as follows.
(1) Chromosomal abnormalities Catcall syndrome with partial deletion of the long arm of chromosome 18.
(2) Lipid disorders Tay-sachs disease, Sandhoffs disease, lactosyl (neuro)sphingomyelinosis, NIEMANN-Pieck disease, alpha-beta-lipoproteinemia (Bassen-kornzwig syndrome).
(3) Mucopolysaccharidosis Hurlers mucopolysaccharidosis, homocystinuria.
(4) Mineral metabolism defects and their metabolism Menkes disease, juvenile diabetes mellitus, cystic fibrosis of the pancreas, systemic ganglioside lipidosis, Zellwage’s disease, Albers-Schönberg disease.
(5) Hereditary retinitis pigmentosa Ushers syndrome, Kesrns-Sayer syndrome, Alstrom syndrome.
(6) Battens disease, infantile neuroaxonal dystrophy, Hallervorden-Spatz disease.
(7) cerebellar ataxia Behr’s optic atrophy, Marie’s ataxia, hereditary motor or sensory polyneuropathy, Charcot-Marie-Tooth disease, olivopontocerebellar cerebellar degeneration.
(8) primary white matter lesions anomalous cerebral white matter degeneration, Krabbers disease, cavernous white matter degeneration (Canaran), nuchal translucency Merzbacher-pelizaeus disease, Cockayne syndrome.
(9) Demyelinating diseases adrenal white matter degeneration, multiple sclerosis.
(10) familial optic atrophy Leber’s disease, infantile optic atrophy (recessive, dominant)
(11) increased intracranial pressure pseudotumor cerebri, intracranial hemorrhage, cranial stenosis, aqueduct obstruction.
III. Treatment measures
Integrated treatment of Chinese and Western medicine: etiological treatment is the first priority.
Once the optic nerve is atrophied, it is almost impossible to heal it, but it is possible to restore or maintain the function of its residual nerve fibers. Therefore, patients should be confident and persistent in their treatment.
Commonly used medications include neurotrophic drugs such as vitamin B1, B12, ATP and coenzyme A; vasodilators and blood-activating drugs such as niacin, dibazol, vitamin E, vincristine, compound salvia, etc. Hyperbaric oxygen, extracorporeal counterpulsation, acupoint injection, acupuncture, etc. have achieved certain results.
Chinese herbal remedies such as tonics and treatment have long been proven effective and can continue to be applied to uncover the finishing touches.
It should also be mentioned that smoking and strong alcohol should be prohibited to enhance the body’s constitution.