Optic nerve atrophy guide
What is optic nerve atrophy?
The optic nerve plays a critical role in the conduction of a visual image from the eye retina to the brain.
The eye's nerve is located in the centre of the retina and is a round or oval area with a diameter of 1.5 to 2 mm. The nerve carries over a million nerves that connect the retina (the eye layer that carries the visual cells) to the occipital lobe (the part of the brain that interprets vision) like a cable.
Optic atrophy is mild to severe damage to the optic nerve fibres that can adversely affect central, peripheral, and colour vision.
The disease is also known as optic neuropathy. Nerve atrophy is characterized by a limited ability to transmit visual information. Although different causes are associated with this disorder, the final result is the same: degeneration or "wasting" of the nerve. Unfortunately, all age categories are exposed to the disease: from birth to adulthood.
Causes of optic nerve atrophy include tumour, trauma, reduced blood supply (ischemia) or oxygen supply, glaucoma, heredity, hydrocephalus, toxins, infection, and rare degenerative disorders. Depending on the genesis of the disease, there are types of damage to the optic nerve.
The symptoms described below may not necessarily mean that the patient has optic nerve atrophy. However, if one or more of these symptoms are present, an appointment with an ophthalmologist is necessary.
- Blurred vision;
- Decreased visual acuity and clarity or a reduction in lateral (peripheral) vision;
- Colour vision and contrast sensitivity may also be affected;
- Bad constriction of the pupil in the light;
- Decreased brightness of one eye compared to the other.
An ophthalmic examination is the first step in the diagnostic process. An eye doctor will evaluate colour and peripheral vision, pupillary response to light, and visual acuity and examine the inside of the eye using an ophthalmoscope. The test helps to examine the optic disc (optic nerve head), the point at the back of the eye where the nerve enters. In optic nerve atrophy, the optic disc becomes pale due to changes in blood flow.
Further testing, such as blood tests and an MRI, may be needed if the results are flimsy.
There is no complete treatment for optic nerve atrophy. Therefore, it is essential to have regular eye examinations (especially if there is a family history) and to see an ophthalmologist immediately if there are any vision changes.
The main goal of treatment is to limit further damage to the optic nerve (if possible). For example, reducing increased pressure in the eye fluid (glaucoma) can prevent further damage to the optic nerve. In addition, the doctor may prescribe glasses to correct vision.
New treatment options
New therapies are being explored worldwide to treat optic nerve atrophy.
- Restorative therapy is an interdisciplinary approach that combines the sciences of ophthalmology and neurology. In this therapy, positive results are achieved by applying weak electrical current pulses that stimulate partially damaged retinal nerve cells and improve the conduction of signals to the brain. Electrical stimulation enhances the optic nerve activity, increases the visual system activity and leads to functional recovery. The uniqueness of restorative therapy is that it is a non-surgical method carried out by non-invasive electrical stimulation of various retinal cells (cones, rods, ganglion cells) and optic nerve fibres. The therapy does not replace damaged cells. Instead, it increases the functionality of the remaining ones.
- Stem cell therapy can be used for injections or transplantation, donor stem cells or your own, obtained from the bone marrow or adipose tissue. Treatment is carried out in a course. The procedure is almost painless and is performed under local anaesthesia. Stem cell treatment of optic nerve atrophy in practice shows promising results.
- Improvement of vision by 15-30% depending on the severity of the disease;
- Restoring the ability to distinguish colours;
- In some cases, an increase in vision by up to 90% is possible.
- Gene therapy is a therapeutic method of treating diseases by correcting defective DNA in patients. New research has shown that the gene responsible for producing a protein known as protrudin stimulates the regeneration of nerve cells and prevents them from dying when damaged. Tests on the eye and optic nerve cells have shown that the protein promotes significant regeneration several weeks after optic nerve injury.
Doctors can achieve significant success in treating optic nerve atrophy thanks to new treatment methods. It is not always possible to restore 100% vision, but they improve vision enough to impact the quality of life.
Statistics and prognosis
Acute and chronic optic neuropathies lead to irreversible loss of vision. Optic nerve damage is one of the most common causes of vision loss. The prevalence of the disease in the world is 1 case per 10,000 people.
Visual impairment in optic nerve atrophy is irreversible; spontaneous recovery has been reported only in exceptional cases. Vision loss is usually minor but then worsens. Atrophy does not affect intellectual development or life expectancy. Patients may have a typical family and social life, although professional integration can sometimes be problematic.
For many years, children with optic nerve atrophy have been followed up at the Department of Pediatric Ophthalmology at the University Hospital Homburg/Saarland. Almost half of these children were born prematurely (46.7%). 69.5% of all patients with optic atrophy had some systemic disease. In 10.4%, doctors detected more than two accompanying diagnoses. 55.3% of all patients with optic nerve atrophy were disabled, and 31.9% had multiple disabilities.
Prematurity and congenital brain lesions are the main findings in pediatric patients with optic nerve atrophy. Such children are seriously ill with severe visual impairment, mental retardation and multiple disabilities. Therefore, for effective therapy, treatment in a specialized centre is necessary.
AiroMedical specialists work with the world's leading ophthalmologists to help patients with persistent visual impairment caused by optic nerve atrophy. As a result, vision restoration becomes a reality.
- American Association for Pediatric Ophthalmology & Strabismus: Optic Nerve Atrophy
- Natural Eye Care: Optic Nerve Atrophy
- Eye & Ear Foundation of Pittsburgh: REGENERATING THE OPTIC NERVE
- National Library of Medicine: Optic Atrophy
- Vision Eye Institute: Optic atrophy
- ResearchGate: Prevalence of Optic Atrophy and Associated Ocular and Systemic Diseases in a Department of Paediatric Ophthalmology