Optic Atrophy is a condition that affects the optic nerve, which is responsible for transmitting impulses from the eye to the brain. 

The optic nerve is a bundle of over 1 million nerve fibers carrying visual messages. 

Optic Atrophy is caused by damage to the optic nerve due to various reasons.

It is closely associated with a group of conditions, some of which are toxins, poor blood flow, or a deficiency of essential nutrients reaching the optic nerve.

This eye condition causes the death of the retinal ganglion cell axons that make up the optic nerve.

It can lead to vision problems, including blindness.

This article shows the types, symptoms, causes, and treatment of Optic nerve atrophy. Continue reading to learn more about the condition. 

Classification of Optic Nerve Atrophy

Optic Atrophy can be classified into Pathologic, Ophthalmoscopic, or Genetic.

Pathologic

Here are the three types of Pathologic optical Atrophy:

  • Anterograde degeneration: Also known as Wallerian degeneration. It begins at the retina and proceeds inwards. It is generally caused by Glaucoma.
  • Retrograde degeneration: Begins from the back of the optic nerve and moves toward the disc.
  • Trans-synaptic degeneration: In this atrophy, the neurons on one side degenerate due to losing neurons on the other. This degeneration is often caused by occipital damage in the womb or infancy.

Ophthalmoscopic

Here are some types of Ophthalmoscopic optic Atrophy:

  • Primary: Nerve fibers in the optic nerve die and are replaced by glial cells without changing the structure of the optic nerve. As a result, the retinal disc looks white instead of pink-yellow.
  • Secondary: The optic nerve fibers break down because there is too much growth and invasion of glial tissue. This makes the area around the retina look very different on eye exams.
  • Consecutive: Usually caused by high Myopia, Retinitis Pigmentosa, and a few other conditions that make the retina waxy or pale and lead to the loss of arteries in the area.
  • Glaucomatous: In this optic Atrophy, the high eye pressure from Glaucoma damages the optic nerve.
  • Circulatory: In this condition, the blood supply to the optic nerve is cut off.
  • Temporal pallor: This can be due to an injury to the optic nerve or insufficient food, which makes the optic nerve go hungry.

Genetic

There are three forms of Genetic Optic atrophy.

All three conditions start with the gradual death of nerve cells in the retina, and the optic nerve wastes away. 

This loss is linked to genetic changes that can be passed down from generation to generation.

Good to Know
The three forms of Genetic optic Atrophy are:

  • Congenital or infantile
  • Leber’s optic Atrophy
  • Behr hereditary optic atrophy
  • Symptoms of Optic Nerve Atrophy

    The symptoms of optic Atrophy relate to a change in vision, specifically:

    • Blurred vision
    • Difficulties with peripheral (side) vision
    • Problems with color vision
    • A reduction in sharpness of vision

    Causes

    Most commonly, optic nerve atrophy occurs without a known or proven cause.

    Causes leading to optic atrophy range from an eye injury or trauma to systemic eye conditions and diseases. 

    Some causes of optic nerve damage include:

    Optic neuritis

    It occurs when the optic nerve is inflamed due to autoimmune disorders and viral, fungal, and bacterial infections.

    Optic Neuritis can also happen due to parasitic diseases, toxins, allergies, digestive problems, diabetes, or poor circulation. 

    You might notice that when they move their eyes, the pain is worse. 

    When the myelin covering is attacked by inflammation, the optic nerve swells and is damaged over time.

    Glaucoma

    An elderly man facing issues with Glaucoma
    Glaucoma Patient

    Glaucoma is one of the significant causes of irreversible blindness. 

    It is marked by the death of Retinal Ganglion Cells (RGCSs) and the loss of their axons.

    It can also cause Atrophy of the optic nerve and the failure of neurons in the lateral geniculate nucleus and the visual cortex.

    Toxic optic neuropathy

    Optic Atrophy can result from medications and toxins that damage the optic nerve, causing gradual or sudden vision loss. 

    Other toxins that can cause damage include Methyl alcohol (moonshine), Ethylene glycol (antifreeze), Cyanide, Lead, and Carbon monoxide.

    Certain drugs, including Ethambutol and Topiramate (Topamax), are optic nerve toxins. They can cause narrow-angle Glaucoma.

    Amiodarone can cause blurred vision and ischemic optic neuropathy. 

    Lack of nutrition

    Protein, B vitamins, vitamin B12, and folic acid deficiency may cause optic nerve atrophy.

    Vitamin B12 deficiencies are caused due to poor nutrition, starvation, poor absorption, or alcoholism. 

    Other medical conditions

    Optic nerve atrophy can also result from a tumor or other lesion pressing on the optic nerve.

    It can also stem from eye movement muscle enlargement, seen in people with Hyperthyroidism (Graves’ disease).

    If left untreated, Syphilis can also damage the optic nerve. Brain tumors or strokes may cause optic nerve atrophy.

    Diagnosis

    mri scanner
    MRI Scanner

    Some tests may help in the correct diagnosis of the eye condition.

    If your ophthalmologist suspects you have Optic Atrophy, they will examine your eyes with an ophthalmoscope. 

    The doctor will examine the optic disc at the back of the eye and where the optic nerve enters. 

    The optic disc will be pale in optic Atrophy due to a change in blood vessel flow. Color vision and contrast sensitivity can also be tested.

    Your doctor can ask about your family history to rule out genetic conditions. 

    They may also suggest a blood and urine analysis if they suspect toxins or vitamin deficiencies.

    Brain magnetic resonance imaging (MRI) may show a tumor or other structure putting pressure on the optic nerve.

    Your doctor may recommend Optical coherence tomography (OCT), visual field test, and Visual Evoked Response (VER). 

    Treatment

    Unfortunately, there is no effective treatment for optic Atrophy. 

    Recent gene therapy trials for Leber’s atrophy have been successful. 

    In the future, gene therapy may promise to treat other types of optic Atrophy.

    However, the objective is to limit further optic nerve damage if possible.

    Reduced fluid pressure around the brain and spinal cord is a potential strategy for preventing vision loss.

    Your doctor might suggest eye drops such as Azopt Eye Drop.

    Once optic nerve fibers are lost, they never regenerate or heal. 

    If the cause can be identified, corrected, or managed, it is sometimes possible to reduce or prevent further damage. 

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    Prevention

    Good nutrition and lifestyle changes are essential for maintaining healthy optic nerves.

    You can do some things to prevent this condition. Some of them are:

    • You can try including ginger, parsley, cabbage, and carrots. Consuming beets, endive, wheat grasses, and berries may also be helpful.
    • Antioxidants can help in preventing and treating optic nerve disorders.
    • Gypenosides, a Chinese medicinal plant, might also help protect the optic nerve.
    • Avoid smoking as it increases exposure to Hydrogen cyanide.
    • You can also try eye exercises to improve your eye health.
    Warning
    Check with your doctor before making any dietary changes. They will recommend the best diet for you.

    Conclusion

    Optic nerve damage is not a disease in itself. It is a symptom of severe underlying conditions such as Glaucoma.

    It can cause symptoms such as reduced sharpness and blurriness in your vision.

    Glaucoma and other medical conditions, such as Syphilis and tumors, can cause Atrophy in your optic nerves. Exposure to toxins and certain medicines can result in optic nerve atrophy.

    If you experience any of these symptoms, check with your doctor. You may need to undergo tests such as MRI and VER.

    There is no proven treatment for this eye condition. However, there are ways to reduce discomfort.

    Check with your doctor for the best possible treatment course.

    Frequently Asked Questions

    What causes the atrophy of the optic nerve?

    Optic nerve atrophy is caused due to eye conditions such as Glaucoma and optic neuritis. It can also result from other medical issues like Syphilis and tumors. Optic Atrophy can also stem from exposure to toxins and certain medications.

    Is optic nerve atrophy serious?

    Optic nerve atrophy is not a severe condition in itself. However, it can indicate some severe conditions related to the eyes and the body, such as Tumors, Glaucoma, etc.

    Can optic nerve atrophy be treated?

    There is no cure or treatment for optic Atrophy. Therefore, it’s essential to have regular eye exams and to see your ophthalmologist immediately if you have any changes in your vision.

    Citations:
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