The clinical manifestations of optic nerve atrophy
Mainly manifested decreased visual acuity and the optic disc was off-white or pale. Normal optic disc color is a variety of factors. Under normal circumstances, the majority of disc temporal side of the color of light than the nasal and temporal side of the extent of pale and physiological cup size. Infant color often pale optic disc, or check the eye pressure caused by optic disc caused by ischemia. Therefore can not alone whether the optic disc structure and color of the normal diagnosis of optic atrophy, we must observe the blood vessels and peripapillary retinal nerve fiber layer, whether there are changes, especially in color vision such as vision inspection, comprehensive analysis, in order to ascertain the extent of optic disc pale. Peripapillary nerve fiber layer of slit-like lesions may occur, or wedge-shaped defects, the former becomes more black, for the retinal pigment layer exposed; the latter was more red, as the choroid exposure. If the damage occurred on the upper and lower edge of optic disc area, will be better able to identify, especially because the area of nerve fiber layer thickness, if the lesion away from the optic disc area, as these areas lead thin nerve fibers is difficult to find. Often accompanied by focal atrophy peripapillary nerve fiber layer has prompted lesions, nerve fiber layer is caused by thinning in the area.
1. Primary optic atrophy
Primary optic atrophy (primary optic atrophy) is due to sieve after intraorbital, tube, intracranial optic nerve, and chiasm, optic tract and lateral geniculate body of the damage caused by optic atrophy, so-called descending optic atrophy (descending optic atrophy).
Descending optic atrophy of the retinal changes is limited to optic disc, showing the optic disc color was gray, the border is extremely neat. As the nerve fiber atrophy and loss of myelin, physiological depression appears slightly larger than the dish slightly darker pale and gray-blue dots can be seen-shaped sieve plate. The retina and retinal vessels were normal.
Cases of primary optic atrophy in each patient, we must conduct a careful analysis of the vision. Clinically, one can often see patients with pituitary tumors due to vision loss and the first patient in the eye, because eye doctors ignored perimetry and misdiagnosis or missed diagnosis, resulting in the treatment of patients adversely affected by the timing.
2. Secondary optic atrophy
Secondary optic atrophy (secondary optic atrophy) is due to a long-term optic disc edema, or severe inflammation of the optic disc caused by optic atrophy. Multiple lesions confined to disc and its surrounding areas, so its fundus changes is limited to optic disc and adjacent retina. Disc due to glial proliferation and white, optic disc boundary is unclear, physiological depression has been filled by glia, thus physiological depression disappeared, sieve plate can not see the check. Disc in the vicinity of the retinal arteries, or accompanied by a variable thin white sheath, retinal vein may be thicker and curved. Posterior pole retina may also be residues that are not absorbed by bleeding and hard exudation.
Secondary optic atrophy, most patients have completely lost vision, a small number of patients remaining part of the vision, their vision is also Duocheng clear concentric narrowing.
3. Ascending optic atrophy
Uplink optic atrophy (ascending optic atrophy) is due to the extensive retinal or choroidal lesions, causing damage to retinal ganglion cells caused by optic atrophy, therefore, also known as retinal optic atrophy (retinitic optic atrophy), or the continuity of optic atrophy (consecutive optic atrophy). Almost all large-scale chorioretinopathy can cause ascending optic atrophy. For example: central retinal artery occlusion, retinitis pigmentosa, severe inflammation of the retina and choroid, as well as advanced glaucoma transformation.
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