Ischemic neuropathy of the optic nerve
Ischemic neuropathies develop for many reasons. There are three pathogenetic factors of the disease:
· Violation of the general hemodynamic state, when a person is sick with hypertension or hypotension, atherosclerosis, diabetes mellitus, diseases of large vessels, blood diseases.
· Changes in some areas of the walls of blood vessels with atheromatosis, and other disorders of their active endocrine organ (endothelium).
· Increased blood clotting and lipoprotein changes.
Anterior and posterior ischemic neuropathy is distinguished.
Anterior ischemic neuropathy (PIN) is diagnosed when there is insufficient blood circulation in the anterior part of the eyeball or, in medical terminology, in the intrabulbar zone of the optic nerve. The disease is an ocular symptom of many systemic diseases. Most people with this pathology suffer from hypertension, cardiovascular disorders, vascular atherosclerosis.
People with diabetes, hypotension, rheumatism are on the risk list. Much less often, ischemia has nothing to do with blood diseases, with endocrine problems. In the history of some patients, there may be a complication after the action of anesthesia or removal of a clouded lens. Among the signs and symptoms, the age of the patients is noted, these are women and men from 30 to 85 years.
Disturbance of blood circulation in the vessels of the eye nerve has a great influence on the development of the disease. Usually one eye is involved in the pathological process, but damage to both visual organs can occur. IDUs may occur suddenly after a night's rest, lifting heavy objects, During ophthalmoscopy, you can see the edematous disc of the optic nerve, discoloration, tortuous, dark dilated veins, minor hemorrhages. The acute period lasts 1-1.5 months, while the condition of the eye is severe, hemorrhagic manifestations are not expressed. After this period, the edema decreases, the hemorrhage resolves, the optic nerve undergoes atrophy.
Posterior ischemic neuropathy (ZIN) is a rather rare phenomenon, which is
acute ischemic disorder in the optic nerve behind the eyeball, in the intraorbital zone. The symptoms and course of this type of neuropathy are similar to those of IDUs, but due to the absence of changes in the fundus even in the acute period, diagnosis is difficult.
The color of the optic disc remains unchanged, with clear boundaries. Over time, disc discoloration and optic nerve atrophy are noted after about 46 weeks. With ZIN, lesions are noticeable only in one eye, pigmentary degeneration of the retina, narrowing of the visual field, sectoral loss, paracentral defects of the visual field and other gross changes are observed.
Over time, vascular disorders also appear on the other eye, they are manifested by acute circulatory disorders, a decrease in visual acuity. With the right treatment, vision is restored or the condition of the eye remains at the same level.
Optic neuropathy
Optic neuropathy can be toxic. Toxic neuropathy is a consequence of the use of methyl alcohol and tobacco and alcohol products. This leads to degenerative damage to the optic nerve. Methyl alcohol is the greatest danger of a sharp progressive decline in visual acuity.
In addition, the pupils expand, there is a lack of reaction to light. After a time after poisoning, hyperemia of the optic nerve head develops in the fundus and blindness occurs. The acute period of toxic neuropathy is characterized by headache, nausea, vomiting, and a coma often occurs.
First aid for methyl alcohol poisoning is to remove the poison from the body.
Patients are prescribed gastric lavage, laxatives. Since poisoning with this type of alcohol is extremely dangerous, the sooner the patient is taken to the emergency room, the more chances are to save his life. Only a comprehensive treatment and study of the general vascular pathology of the patient will quickly achieve positive results.
Treatment of ischemic neuropathy involves the use of antispasmodic and thrombolytic agents. They use anticoagulants, symptomatic drugs and B vitamins. The effectiveness of magnetotherapy and methods of electro and laser stimulation of the optic nerve has been proven.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".
