Optic atrophy in one eye

1. Causes

1. Primary optic atrophy

It is often caused by retrobulbar neuritis, hereditary optic neuropathy (Leber's disease), orbital tumor compression, trauma, neurotoxins, etc. These lesions occur at the back of the eye.

2. Secondary optic atrophy

Common ones include papillitis, optic disc edema, retinal choroiditis, retinitis pigmentosa, central retinal artery occlusion, quinine poisoning, ischemic optic disc disease, glaucoma, etc.

3. Intracranial lesions

Intracranial inflammation, such as tuberculous meningitis or chiasmatic arachnoiditis, can cause descending optic atrophy. If the inflammation spreads to the optic disc, it can manifest as secondary optic atrophy. The increased intracranial pressure caused by intracranial tumors can cause papilledema and then form secondary optic atrophy.

2. Clinical manifestations

The main symptoms are decreased vision and gray or pale optic disc. When the nerve fiber layer around the optic disc is damaged, a slit-shaped or wedge-shaped defect may appear. The former becomes darker, indicating exposure of the retinal pigment layer; the latter becomes redder, indicating exposure of the choroid. If the lesion occurs in the upper and lower edges of the optic disc, it is easier to identify because the nerve fiber layer in this area is particularly thickened. If the lesion is far away from the optic disc, it is difficult to find because the nerve fiber layer in these areas is thinner. Focal atrophy around the optic disc often indicates a lesion in the nerve fiber layer, which is caused by thinning of the nerve fiber layer in this area.

Although it can be detected by funduscopy, it is easier to detect with a red-free ophthalmoscope and fundus photography. There are usually 9 to 10 small blood vessels in the optic disc. If the optic nerve atrophies, the number of these small blood vessels will decrease. At the same time, thinning, stenosis and occlusion of the retinal arteries may be seen.

Optic atrophy is divided into primary and secondary types: in the former, the optic disc has clear boundaries, and the physiological depression and cribriform plate are visible; in the latter, the boundaries are blurred, and the physiological depression and cribriform plate are not visible.

Treatment

1. Treatment of the cause

Once the optic nerve atrophies, it is almost impossible to heal it, but it is entirely possible for its remaining nerve fibers to recover or maintain their function. Therefore, patients should be encouraged to have confidence and persist in treatment.

2. Medication

Commonly used ones include neurotrophic drugs such as vitamin B1, B12, ATP and coenzyme A, vasodilators and blood circulation and blood stasis drugs such as niacin, dibazole, vitamin E, vinca, compound salvia miltiorrhiza, etc. In recent years, certain effects have been achieved through hyperbaric oxygen, external counterpulsation, acupuncture injection of 654-2, etc.