Атрофия зрительного nerve: лечение, симптомы,causes of complete or partial failure

Update: December 2018

On качество жизни, в первую очередь, влияет состояние нашего
health Free breathing, clear hearing, freedom of movement – everything
It is very important for a person. Onрушение работы даже одного органа
can lead to a change in the usual way in the negative direction.
Onпример, вынужденному отказу от активных физических нагрузок (бега
in the mornings, gym visits), eating tasty (and fat)
dishes, intimate relationships, etc. This is most pronounced when
поражении органа view.

Most eye diseases are quite favorable.
for a person because modern medicine can cure them or
reduce the negative effect to no (correct vision,
improve color perception). Complete and even partial atrophy
зрительного nerve не относится к этому «большинству». With этой
pathologies, as a rule, the functions of the eye are significantly disturbed and
irreversible. Often patients lose their ability to perform even
daily affairs and receive disability.

Can this be prevented? Yes you can. But only when
timely detection of the cause of the disease and the
adequate treatment.

Что такое атрофия зрительного nerve

It is a condition in which the nervous tissue experiences acute
lack of nutrients, because of which it ceases to perform its
functions. If the process continues long enough, neurons
gradually begin to die off. Over time, it affects
a growing number of cells, and in severe cases – all nervous
trunk. Restore eye function in such patients will
практически is impossible.

атрофия зрительного nerveTo understand how this
disease, it is necessary to submit the course of the impulses to the brain
structures. They are conventionally divided into two portions – the lateral and
medial. The first is the “picture” of the surrounding world, which
sees the inside of the eye (closer to the nose). The second is responsible for
perception of the outer part of the image (closer to the crown).

Both parts are formed on the back of the eye, from the group
special (ganglion) cells, then sent to
various brain structures. This path is quite difficult, but
one moment in principle – almost immediately after leaving
eye socket occurs intersection internal portions. What’s this

  • The left tract perceives the image of the world from the left half
  • The right one transports the “picture” from the right halves to the brain.

Therefore, damage to one of the nerves after he left
eye socket, will change the function of both eyes.


In most cases, this pathology does not occur.
independently, but is a consequence of another eye disease. Highly
важно учитывать причину атрофии зрительного nerve, а точнее место
its occurrence. From this factor will depend on the nature
symptoms of the patient and features of therapy.

There may be two options:

  1. Ascending type – the disease arises from that part of the nervous
    ствола, которая ближе к глазу (до overlap);
  2. Descending form – the nervous tissue begins to atrophy from above
    вниз (выше overlap, но до входа в мозг).

Onиболее частые причины этих состояний представлены в таблице

Typical causes a brief description of

 Ascending type

Glaucoma This word hides a number of violations that
combines one feature – increased intraocular pressure. Fine,
it is necessary to maintain the correct shape of the eye. But at
glaucoma, pressure inhibits the flow of nutrients to the nervous
tissues and makes them atrophic.
Intrabulbar neuritis Infectious process that affects neurons in the ocular cavity
apple (intrabulbar form) or behind it (retrobulbar
type of).
Retrobulbar neuritis
Токсические поражения nerve The impact of toxic substances on the body leads to decay
nerve cells. A damaging effect on the analyzer have:

  • Methanol (several grams are enough);
  • Joint use of alcohol and tobacco in significant
  • Industrial waste (lead, carbon disulfide);
  • Medicinal substances with increased susceptibility
    patient (Digoxin, Sulfalen, Co-Trimoxazole, Sulfadiazine,
    Sulfonamide and others).
Ischemic Disorders Ischemia is a lack of blood flow. May occur when:

  • Hypertension 2-3 degrees (when blood pressure is constantly higher,
    than 160/100 mm Hg);
  • Diabetes (type does not matter);
  • Atherosclerosis – deposition of plaques on the walls of blood vessels.
Stagnant disk По своей природе, это отек начальной части нервного the trunk. is he
may occur in any conditions associated with an increase
intracranial pressure:

  • Injuries to the skull;
  • Meningitis;
  • Hydrocephalus (synonym – “dropsy of the brain”);
  • Any oncological processes of the spinal cord.
Опухоли nerve или окружающих тканей, располагающиеся до
Pathological tissue growth can lead to compression

Descending type

Toxic lesions (less common) In some cases, the toxic substances described above may
damage neurocytes after overlap.
Tumors of the nerve or surrounding tissue, located after
Cancer is the most frequent and most dangerous cause.
the downward form of the disease. They are not divided into
benign, as the complexity of treatment allows you to call all
malignant brain tumors.
Specific lesions of the nervous tissue In the outcome of some chronic infections that occur with
destruction of neurocytes throughout the body, can partially / cavity
to atrophy the optic nerve trunk. To such specific
lesions include:

  • Neurosyphilis;
  • Tuberculous damage to the nervous system;
  • Lepra;
  • Herpetic infection.
Abscesses in the cranial cavity After neuroinfections (meningitis, encephalitis and others) can
occur limited cavity connective tissue walls –
abscesses. If they are located near the optic tract,
there is the likelihood of pathology.

Treatment of optic atrophy is closely related to the detection of
the reasons. Therefore, to clarify it should pay close
Attention. Symptoms that may
allow to distinguish the ascending form from the descending one.


Вне зависимости от уровня поражения (выше overlap или ниже)
There are two reliable signs of optic atrophy – prolapse
visual fields (“anopsy”) and reduction in visual acuity (amblyopia).
How much they will be expressed in a particular patient depends on
severity of the process and the activity of the cause of the disease.
Consider these symptoms in more detail.

Loss of visual fields (anopsia)

What does the term “field of view” mean? In essence, this is just a zone,
which a person sees. To submit it, you can close
half eyes on either side. At the same time you see only half
pictures, as the analyzer cannot perceive the second part.
We can say that you have “dropped out” one (right or left) zone.
That is what anopsy is – the disappearance of the visual field.

Neurologists share it in:

  • temporal (half of the image closer to the temple)
    and nasal (the other half of the nose);
  • right and left, depending on which side falls out

With partial atrophy of the optic nerve, symptoms may or may not
to be, since the remaining neurons transmit information from the eye to the brain.
However, if there was a defeat through the entire thickness of the trunk – this
A sign is sure to appear in the patient.

What zones will fall out of the patient’s perception? It depends on the
the level at which the pathological process is located and on the degree
cell damage. There are several options:

View atrophy Lesion level What does the patient feel?
Full – damaged the entire diameter of the nerve trunk (signal
interrupted and not held in the brain)
До overlap (при восходящей форме) The organ of vision from the affected side completely ceases
После overlap (при нисходящем типе) Right or left visual fields appear on both eyes.
Incomplete – only part of the neurocytes do not perform their function.
Most of the image is perceived by the patient.
До overlap (при восходящей форме) Symptoms могут отсутствовать или выпадает поле зрения на одном
out of sight. Which one depends on the location of the atrophy
После overlap (при нисходящем типе)

This neurological symptom seems difficult to understand.
however, thanks to him, an experienced specialist can identify the place
lesion without any additional methods. Therefore very
It is important that the patient speaks openly to his doctor about any
signs of loss of visual fields.

 Reduced visual acuity (amblyopia)

This is the second sign that is observed in all patients without
exceptions. Only the degree of its manifestation varies:

  1. Легкая – характерна для начальных проявлений process. A patient
    does not feel reduced vision, the symptom manifests itself only when
    careful consideration of distant objects;
  2. Medium – occurs when a significant portion of neurons are affected.
    Remote objects are practically invisible, at a short distance.
    the patient has no difficulty;
  3. Heavy – indicates the activity of the pathology. Keenness
    reduced so that it becomes difficult to even objects
    located nearby;
  4. Blindness (synonymous with amorovoz) is a sign of complete atrophy of the visual
    the nerve.

As a rule, amblyopia occurs suddenly and gradually.
growing, without adequate treatment. If the pathological process
proceeds aggressively or the patient has not timely applied for
using – there is the likelihood of developing irreversible blindness.


As a rule, problems with the detection of this pathology occur
seldom. The main thing is for the patient to seek medical attention in a timely manner.
using To confirm the diagnosis, he is referred to an ophthalmologist.
for examination of the fundus. This is a special technique with
through which you can examine the initial section of the nervous
the trunk.

how проводится офтальмоскопия. In classic
option, the fundus examines the doctor in a dark room, with
using a special mirror device (ophthalmoscope) and
light source. The use of modern equipment
(electronic ophthalmoscope) allows you to do this research with
greater accuracy. The patient does not need any preparation for
procedure and special actions during the inspection.

Unfortunately, ophthalmoscopy does not always detect
changes, as the symptoms of a lesion occur earlier than
tissue changes. Laboratory tests (blood, urine,
cerebrospinal fluid) are non-specific and have only
auxiliary diagnostic value.

How to act in this case? In modern multi-disciplinary
hospitals, to detect the cause of the disease and changes in
nervous tissue, there are the following methods:

Research method Principle of the method Changes in atrophy
Fluorescene Angiography (FAG) A patientу вводят красящее веществу через вену, которое попадает
in the eye vessels. Using a special light emitting device
different frequencies, “illuminate” the fundus of the eye and evaluate it
Signs of insufficient blood supply and tissue damage
Laser tomography of the eye disc (HRTIII) Non-invasive (remote) method of studying ocular anatomy
Change of the initial part of the nerve trunk by type
Optical coherence tomography (OCT) of the optic disc
Using high-precision infrared radiation estimate
tissue condition.
CT / MRI of the brain Non-invasive methods for studying the tissues of our body.
They allow you to get an image at any level, up to
Used to determine the possible cause of the disease. how
usually the purpose of this study is to look for a tumor or
other mass education (abscesses, cysts, etc.).

Therapy of the disease begins from the moment of treatment of the patient, so
how to wait for diagnostic results is irrational. During this time,
pathology may continue to progress, and changes in the tissues
will be irreversible. After clarifying the reasons, the doctor
corrects his tactics to achieve the optimal effect.


It is widely believed in society that “nerve cells are not
restored. This is not entirely correct. Neurocytes can
to grow, to increase the number of connections with other tissues and
take over the functions of the dead “comrades”. However, one property
they are not very important for complete regeneration – the ability to

Можно ли вылечить атрофию зрительного nerve? Definitely not. With
partial lesion of the trunk, medications can improve sharpness and margins
view. In rare cases, even practically restore the ability
пациента see до нормального уровня. If pathological
the process completely disrupted the transmission of impulses from the eye to the brain,
surgery can only help.

For the successful treatment of this disease it is necessary, first of all,
eliminate the cause of its occurrence. This will prevent / reduce
cell damage and stabilizes the pathology. Because
There are a large number of factors causing atrophy, tactics
Doctors may vary significantly in different conditions.
If it is not possible to cure the cause
(malignant tumor, inaccessible abscess, etc.), should
proceed immediately to the restoration of the eye.

Современные способы восстановления nerve

10-15 years ago, the main role in the treatment of atrophy of the visual
nerve отводилась витаминам и ангиопротекторам. Currently,
they have only additional meaning. Come to the fore
drugs that restore metabolism in neurons
(antihypoxants) and increasing blood flow to them (nootropics,
antiplatelet agents and others).

The modern scheme of restoring the functions of the eye includes

  • Antioxidant and antihypoxant (Mexidol, Trimetazidine, Trimectal
    and others) – this group is focused on tissue repair,
    decrease in activity of damaging processes, elimination
    «кислородного голодания» the nerve. In the hospital are introduced
    intravenously, with outpatient treatment, antioxidants are taken in
    tablet form;
  • Microcirculation Correctors (Actovegin, Trental) – improve
    metabolic processes in nerve cells and increase them
    blood supply. These drugs are one of the most important
    components of treatment. Also available as solutions for
    intravenous fluids and pills;
  • Nootropics (Piracetam, Cerebrolysin, Glutamic Acid) –
    neurocyte blood flow stimulants. Accelerate their recovery;
  • The drugs reducing vascular permeability (Emoxipin) –
    protects the optic nerve from further damage. He entered into
    treatment of eye diseases not so long ago and is used only in
    major ophthalmological centers. Enter it parabulbarno
    (a thin needle is carried along the wall of the orbit into the surrounding eye
  • Витамины С, РР, B6, B12 – дополнительный
    component of therapy. It is believed that these substances improve metabolism.
    in the neurons.

The above is a classic treatment for atrophy, but in 2010
year ophthalmologists have proposed a fundamentally new methods
restoration of the eye, using peptide bioregulators. On
Currently, specialized centers are widely used
only two drugs – Cortexin and Retinalamin. During research
it has been proven that they improve the state of vision in almost two

Their effect is realized through two mechanisms – these bioregulators
stimulate the regeneration of neurocytes and limit damaging
processes. The method of their use is quite specific:

  • Cortexin – used as an injection into the skin of the temples or
    intramuscularly. Preferred is the first method, since
    it creates a higher concentration of the substance;
  • Retinalamin – the drug is injected into parabulbar fiber.

The combination of classical and peptide therapy is enough
effective for the regeneration of nerves, however even it is not always
allows you to achieve the desired result. Additionally
stimulate regenerative processes can be using
directed physiotherapy.

Физиотерапия при атрофии зрительного nerve

There are two physiotherapeutic methods, whose positive
action is confirmed by research scientists:

  • Pulsed Magnetotherapy (UTI) – this method is not aimed at
    cell repair, and to improve their work. Thanks
    directed concentration of magnetic fields “thickens” the contents
    neurons, due to which the development and transmission of impulses to the brain
    produced faster;
  • Bioresonance therapy (BT) – its mechanism of action is associated with
    improvement of metabolic processes in damaged tissues and normalization
    blood flow through microscopic vessels (capillaries).

They are very specific and are used only in large regional
or private eye centers due to the need for
expensive equipment. how правило, для большинства пациентов
these technologies are paid, therefore BMI and BT are used sufficiently

Surgical Atrophy Treatment

In ophthalmology there are special operations that
improve visual function in patients with atrophy. They can
divided into two main types:

  1. Redistributing blood flow to the eye area – to strengthen
    the flow of nutrients to one place, you need to reduce it
    in other tissues. For this purpose, some of the vessels on the face are tied up,
    because of what most of the blood is forced to go through the ophthalmic artery.
    These types of interventions are rarely performed, as they can
    lead to complications in the postoperative period;
  2. Transplantation of revascularizing tissues is the principle of this
    surgery consists of tissue transplantation with abundant blood supply
    (parts of the muscle, conjunctiva) in the atrophic area. Through transplant
    new vessels will sprout, which will ensure an adequate flow
    blood to neurons. Such intervention is widespread.
    wider, since it does not practically suffer from other tissues

Several years ago, in the Russian Federation, methods were actively developed
stem cell treatment. However, the amendment to
The country’s legislation has done this research and its application.
results in humans are unlawful. Therefore, at present,
technology of this level can be found only abroad
(Israel, Germany).


The degree of vision loss in a patient depends on two factors –
the severity of the lesion of the nerve trunk and the time of the start of treatment.
If the pathological process затронул только часть нейроцитов, в
in some cases, it is possible to recover almost completely
функции глаза, на фоне адекватной  терапии.

Unfortunately, with the atrophy of all nerve cells and the termination
transmission of impulses, the probability of developing blindness in a patient is high.
The outcome in this case may be a surgical recovery.
tissue nutrition, but such treatment is not a guarantee
восстановления view.


Вопрос: Может ли быть эта болезнь врожденной?

Да, но очень seldom. In this case, all symptoms appear.
the diseases described above. how правило, первые признаки
detected at the age of one year (6-8 months). Important timely
consult an ophthalmologist, since the greatest effect of treatment
observed in children under 5 years old.

Вопрос: Где можно вылечить атрофию зрительного

It should be emphasized once again – completely get rid of this
pathology is impossible. With therapy, you can control the disease and
partially restore visual function but cure it
is impossible.

Вопрос: Часто ли развивается патология у детей?

No, these are quite rare cases. If the child is identified and
confirmed the diagnosis is necessary to clarify whether it is

Вопрос: howое лечение народными средствами
most effective?

Atrophy is difficult to treat even highly active
drugs and specialized physiotherapy. Onродные методики не
will have a significant impact on this process.

Вопрос: Дают ли группы инвалидности при атрофии?

It depends on the степени утраты view. Blindness is an indication
for the appointment of the first group, the sharpness from 0.3 to 0.1 – for

Вопрос: Сколько времени нужно принимать лекарства?
Are there enough courses?

All therapy is taken by the patient for life. In order to
controlling this disease is not short term

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