Atrophy of the optic nerve

Atrophy of the optic nerve. Etiology. Diseases of the optic nerve and retina, diseases of the brain, its membranes and vessels, general intoxication, hereditary causes.

Pathogenesis. Destruction of nerve fibers, replacement of their glial and connective tissue.

Symptoms, course. There are primary and secondary, partial and complete, stationary and progressive atrophy of the optic nerve. With primary atrophy, the optic nerve disc is pale with clear boundaries, formation of a flat excavation, narrowing of arterial vessels of the retina are noted. Vision is reduced. The field of vision is concentrically narrowed, scotomas are detected. In the early stage of secondary atrophy, which occurs after inflammation or stagnant phenomena, the pale disc of the optic nerve has fuzzy boundaries, somewhat protrudes, the veins of the retina are enlarged; In the late stage the picture resembles a primary atrophy. With partial atrophy, functional and ophthalmoscopic changes are less pronounced than with complete atrophy. Progressive atrophy is characterized by a steady decline in vision, stationary - stabilization of visual functions. The diagnosis is based on a characteristic ophthalmoscopic picture and visual impairment.

Treatment. General therapy depending on the underlying disease. To improve the supply of the optic nerve, prescribe nicotinic acid-1 ml of a 1% solution of IV (along with glucose) daily for 10-15 days or inside 0.05 g 3 times daily after meals. Use also nikoshpan (1 tablet 3 times a day), but-shpu inside to 0.04 g or IM in the form of 2% solution of 1-2 ml, dibazole orally in 0.02 g or as IM injections 0.5-1% solution of 1-2 ml daily, nihexine 0.25 g 2-3 times a day, sodium nitrate in solutions in an upward concentration of 2% to 10% of 0.2-0.5 -1 ml. The concentration of the solution is increased every 3 injections (for a course of treatment of 30 injections). Apply a 0.1% solution of strychnine nitrate to 1 ml as injections under the skin of the temple for 0.5 ml (total 20-25 injections); Biogenic stimulants (aloe, FBS, etc.) 1 ml p / c, 30 injections per course; Iv infusion of 10% sodium iodide solution; Vitamins B, and B, ^ in usual doses inside or in / m; Glutamic acid 0.5 g 2-4 times daily before meals for 2 months; Lipocerebrin 0.5 g 2-3 times a day. Oxygen therapy, ultrasound therapy are useful.

The prognosis is serious. The preservation of vision can be expected with the stabilization of partial atrophy.