Causes and risk factors
Primary optic atrophy may arise as a result of cerebral tumors, retrobulbar optic neuritis, glaucoma, traumatic or optic neuropathy, and the occlusion of the central retinal artery or the central retinal vein.
Secondary optic atrophy may arise as a result of chronic optic neuritis, ischemic optic neuropathy, and other secondary causes.
Damage to the optic nerve as a result of alcohol, tobacco, or toxic drugs is an important cause of optic nerve atrophy. Other known causes include degenerative retinal diseases and hereditary forms of optic neuropathies. Viral, bacterial, and fungal infections can also lead to optic atrophy. Radiation optic neuropathy has also been identified.
Certain genetic, vascular, and metabolic causes have also been identified in the etiology of optic atrophy.
Clinical presentation
The patient experiences varying degrees of loss of vision. The central or peripheral vision is affected depending upon the cause. The color vision is also affected.
Upon examination, the following signs may be observed:
- Pallor of the optic disc with reduction in the number of blood vessels
- Delineation of the margin of the optic disc
- Cupping of the optic disc may be present
Depending upon the underlying cause of optic atrophy, various other signs and symptoms may be present.
Investigations
Fundoscopic examination of the eye is performed to visualize the optic nerve and the surrounding structures. A thorough examination of the eye including ‘visual field testing’ is carried out to look for other abnormal signs.
An optical coherence tomography is usually done to observe the eye structures in detail.
Laboratory tests are performed to check for levels of toxins and other substances in the blood in accordance with the suspected underlying cause.
A CT scan of the brain may be suggested.
Treatment
The underlying cause of optic atrophy needs to be identified and treated. The atrophic changes in the optic nerve are largely irreversible. However, steps can be taken to minimize further damage.
Complications
Irreversible loss of vision
When to contact a doctor
Contact a doctor as soon as you experience any degree of loss of vision.
Prevention
Not indulging in alcohol, tobacco, and other toxic substances helps to avoid optic atrophy caused due to these substances.
Systems involved
Ophthalmic, CNS
Organs involved
Eye, optic nerve
Recent updates
Stem cell treatment is being researched upon in the treatment of optic atrophy.
