How to check for the cause of optic nerve atrophy?

Optic nerve atrophy is a difficult disease to treat, and one negligence can worsen the condition. Therefore, we should pay attention to the diagnosis of optic nerve atrophy.

First of all, vision is often significantly reduced, and vision is blurred or not visible at all. Second, the centripetal nature of the visual field narrows. Visual field refers to the area where the corner of the eye is perceived when the eye looks straight forward, it is as important to us as eyesight, if the field of vision is small, you can't see the car coming towards you when crossing the street, and it is easy to have an accident.

In addition, some patients will have dilated pupils and photophobia. If there are any of the above symptoms, the patient should see a doctor as soon as possible, and the doctor will confirm whether there is optic nerve atrophy according to the fundus morphology and visual function (visual acuity, visual field), and then perform X-ray cranial radiograph, CT scan and other examinations, as well as neurological consultation, to look for possible atrophy**.

The main manifestations are vision loss and grayish-white or pale optic discs. There are a variety of factors that determine the normal optic disc tone. Under normal circumstances, the temporal color of the optic disc is mostly lighter than that of the nasal side, and the degree of temporal color is related to the size of the physiological cup.

The optic disc is often pale in infants, or it is caused by optic disc ischemia caused by compression of the eyeball during examination.

The optic disc usually has 9 to 10 small blood vessels, and if the optic nerve atrophies, the number of these small blood vessels decreases. At the same time, retinal artery thinning, stenosis and occlusion can be seen, but this phenomenon is not all optic nerve atrophy, generally retrobulbar optic nerve atrophy has no effect, if optic nerve atrophy is accompanied by retinal vascular changes, it must directly affect retinal blood vessels, in order to occur retinal vascular changes.

The diagnosis of optic nerve atrophy is generally based on three main considerations: first, to see whether there is a decrease or defect in vision and visual field. If the optic nerve is atrophied, the visual acuity will generally decrease significantly, and the visual field will also be defective.

Second, it depends on the results of the examination. Optic nerve fiber layer analysis can be done to determine whether the optic nerve fiber layer is thin, because optic nerve atrophy usually causes damage to the optic nerve tissue due to various reasons, in which case the optic nerve tissue becomes very thin, which is also an essential basis for diagnosing optic nerve atrophy. Third, mainly depends on the performance of the optic disc, after the optic nerve atrophy, the color of the optic disc will become pale and white, and the cup-to-disc ratio is usually relatively large, and it will overshoot the code or above.

The main methods of optic nerve atrophy are primary disease, drugs, and surgery.

1.Primary disease**. Optic nerve atrophy caused by glaucoma can be controlled by drugs or surgery**, and optic nerve atrophy caused by intracranial tumors can be surgically performed**, and most patients can get a better recovery of vision after surgery.

Optic nerve atrophy caused by optic nerve tube fracture after trauma usually suggests surgery to decompress and remove the fracture fragment at an early stage.

2.Drugs**. Drugs** mainly include glucocorticoid drugs, vitamin B group, and drugs that agate the vegetative nerve.

3.Surgery**. There are two main types of surgeries** due to intracranial masses: craniotomy and minimally invasive surgery. The specific type of surgery depends on the location and size of the tumor.

What are the manifestations of optic nerve atrophy? What are the manifestations of optic nerve atrophy? There are many people who feel that their eyes are particularly uncomfortable recently, their vision is getting worse and worse, sometimes they see things blurry, their eyes are red, and there is blood in their eyes, which is actually the most obvious symptom of optic nerve atrophy.

First of all, optic nerve atrophy disorder is mainly manifested as vision loss, and the eyes of the limbs are grayish or pale.

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The occurrence of eye diseases has a great impact on our normal vision, and optic nerve atrophy can be said to be a relatively common ophthalmic disease, which will affect the normal work and life of patients, so in the face of the emergence of optic nerve atrophy disease, we should accept it as soon as possible, but we must make a good diagnosis before **, so how should we diagnose optic nerve atrophy disease?

Optic nerve atrophy actually means that our optic nerve is damaged, which will cause certain changes in the patient's field of vision, and in severe cases, it will directly affect the patient's vision, so we should diagnose the occurrence of optic nerve atrophy disease as soon as possible, and the diagnosis can be confirmed by the following four examination methods.

1. We must first pay attention to whether there is an abnormality in the visual field, patients with optic nerve atrophy generally have symptoms of abnormal visual field of the eye, its main manifestation is that there is a scotoma in the visual field or a scotoma in the side center, this situation can only be checked by professionals, so observing whether the visual field is abnormal is a necessary examination to confirm the diagnosis of optic nerve atrophy.

2. Examination of fundus changes, this is also a very important examination method to confirm the diagnosis of optic nerve atrophy, fundus changes are a kind of intraocular lesions, and the main symptoms of patients with optic nerve atrophy are that the edges are not covered and the optic disc is congested.

3. Fundus fluorescein angiography examination, which is the most critical examination to confirm the diagnosis of optic nerve atrophy disease, and it is also of great significance for optic nerve atrophy disease.

4. Electrophysiological examination, which is also a must be done for patients with optic nerve atrophy, is very helpful for the diagnosis of optic nerve atrophy disease, so you must not ignore this examination.

If you have optic nerve atrophy, you should first do an ophthalmologic examination to check your visual acuity, fundus, intraocular pressure, slit lamp, visual field, electroretinography, visual evoked potentials, color vision, fundus fluorescein angiography, optic nerve OCT, fundus photography, etc. The second is a neurological examination, CT and MRI examination of the head or ocular to determine whether there is tumor compression, hemorrhage, embolism, foreign body, fracture, hematoma, etc. in the skull or orbit. Optic nerve atrophy refers to any disease that causes retinal ganglion cells and their axonal lesions, causing optic glial hyperplasia, loss of retinal optic ganglion cells, degeneration or necrosis of nerve fibers, and serious dysfunction of the optic nerve.

For optic nerve atrophy caused by inflammation, blood tests and cerebrospinal fluid examination are required. Hereditary optic nerve atrophy can be tested for genes, and mutations in mitochondrial DNA with corresponding gene loci mostly occur in 3460, 11778, and 14484. Optic nerve atrophy caused by immune system disorders and metabolic syndrome requires rheumatology and immunology examinations, and consultation with neurology and rheumatology and immunology if necessary.

Examination of optic nerve atrophy is not diagnostic if the optic disc is pale or pale based on the degree of the eye alone, and the diagnosis can only be made by combining visual function tests. The main tests to be done to confirm the diagnosis of optic nerve atrophy are: visual field examination

Patients with optic nerve atrophy usually present with abnormal visual field of the eye, so visual field testing is essential. Fundus examination: To test for fundus changes, the fundus can be examined by an ophthalmoscope without red light.

The main symptoms of patients with optic nerve atrophy are: blurred margins, optic disc congestion, etc. Visual electrophysiological testing:

Electrophysiologic studies may reveal characteristic abnormalities. Visual electrophysiological tests, including electroretinography (ERG), electrooculography (EOG) and visual evoked potentials (VEP), have certain auxiliary significance for the diagnosis and prognosis. Fundus fluorescein angiography:

The early stage is of little significance, and the late stage can be seen with decreased optic disc fluorescence and later strong fluorescence. ,

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What tests are available for optic nerve atrophy?

Visual field test. Patients with optic nerve atrophy may have a centripetal narrowing, sector defect, hemianopia, or central scotoma.

Optic disc examination. Optic disc examination in patients with optic nerve atrophy may show optic disc color and optic disc vascular changes.

The first examination to be done for optic nerve atrophy is visual evoked potential examination, which can find that the peak of P100 will be delayed or the amplitude will be significantly decreased during the latent period, and VEP can objectively evaluate the visual function, which can be of great significance for the diagnosis of OA, the monitoring of the condition and the determination of efficacy.

The second kind of examination is the quantitative threshold examination procedure of the central visual field of the computerized automatic perimetry, which can see the centripetal narrowing, and some will also indicate the disease, such as bitemporal hemianopia should exclude intracranial optic chiasm mass lesions, and the huge center or paracentral scotoma should exclude Leber hereditary optic neuropathy, this examination can not only be used for the evaluation of visual function, but also has great significance for the diagnosis, disease monitoring and efficacy of OA.

The third kind of examination is skull or ocular CT and MRI examination, which can see the intracranial or intraorbital mass lesions of patients with compressive and infiltrative optic neuropathy compressing the optic nerve, and patients with neuromyelitis optica, multiple sclerosis and other patients can see the central nervous system white matter demyelinating lesions, which can be used to exclude or confirm compressive and infiltrative optic neuropathy and demyelinating lesions in the diagnosis of OA.

The fourth kind of examination is genetic testing technology, which is to detect mitochondrial DNA or nuclear genes through blood, other body fluids or cells, and it is possible to see the mutation of the corresponding gene locus in patients with OA caused by hereditary optic neuropathy, which can be excluded or confirmed in the diagnosis of OA.

Optic nerve atrophy should be checked out, so patients who suspect that they have optic nerve atrophy should go to the hospital in time, so that their vision is not affected, if it is indeed optic nerve atrophy, they should be actively carried out, so as to avoid more unpredictable consequences, pay more attention to rest in the process, avoid eye fatigue, and eat more food that is beneficial to the eyes.

Three bases can confirm the diagnosis:

Clause. 1. Vision loss, which is very important to see varying degrees of vision decline after the formation of optic nerve atrophy;

Clause. 2. Visual field defect, optic nerve atrophy may form a tubular visual field, that is, the central vision is okay, but the peripheral vision is all gone, and only the tubular range in front of the eye can be seen, which is a typical visual field defect manifestation of optic nerve atrophy;

Clause. Third, fundus examination, you can see that the color of the optic disc is pale, and the cup-to-disc ratio will become larger, under normal circumstances, it is only possible, in this case it is possible to even larger, after the optic nerve fiber layer analysis, it will be found that the fiber layer is obviously thinner.

After passing the above three tests, the diagnosis of optic nerve atrophy can be confirmed, and there is no definite and effective way to treat this disease.

The symptoms of optic nerve atrophy are complex and complex, and the symptoms reflected in the atrophy of the optic nerve are different depending on the location, mainly including: vision changes and visual field changes.

The causes of optic nerve atrophy are varied, such as ischemia, intoxication, genetics, tumor compression, intracranial hypertension, optic nerve inflammation, trauma, etc., which are divided into primary and secondary optic nerve atrophy. The primary disease is usually a problem with the optic nerve and optic center in the posterior part of the eyeball, which is a descending atrophy. Secondary optic nerve atrophy is a primary disease of the optic disc and retina, which is ascending.

Therefore, optic nerve atrophy will be accompanied by the manifestations of ** diseases, which are systemic, such as headache, dizziness, liver and kidney and other organ damage. There are also ocular local, such as eye pain, corneal conjunctival lesions, etc. After optic nerve atrophy, the following typical manifestations will occur:

Visual field changes: visual field changes occur depending on the location and extent of optic nerve atrophy, and visual field changes may be the first symptom of optic nerve atrophy. Thinning of the nerve fiber layer around the optic disc in the fundus.

Changes in visual acuity, optic nerve atrophy leads to gradual loss of vision, and in severe cases, blindness.

Optic nerve atrophy may be caused by other disorders of the eye or by some space-occupying lesions of the brain.

1. Glaucoma will continue to increase intraocular pressure, resulting in atrophy of the optic nerve and visual field defects;

2. It may be caused by optic neuritis and ischemic optic neuropathy;

3. It may also be caused by some space-occupying lesions of the brain, such as pituitary tumors, which may lead to atrophy of the optic nerve and visual field.

Optic nerve atrophy refers to the lesion of the retina, cells and their axons caused by any disease, usually as axonal degeneration of ganglion cells between the retina and the lateral geniculate body. **：

1. Intracranial hypertension or intracranial inflammation. For example, tuberculous meningitis.

2. Retinal diseases. These include vascular retina** vein occlusion inflammation. Retinal and choroiditis degeneration. For example, retinitis pigmentosa.

3. Optic neuropathy. These include vascular, such as ischemic optic neuropathy. Inflammation, such as optic neuritis, lead and other metal poisoning, syphilitic lesions.

4. Compressive disease, intraorbital or intracranial tumor hemorrhage.