secondary optic atrophy
Introduction
Introduction Secondary optic atrophy is caused by optic nerve fibrosis, glial and connective tissue mixed to fill the optic disc. After the late optic disc edema or optic discitis, the optic disc is covered by connective tissue of exudate, grayish white, gray or grayish red, the edge is unclear, the physiological depression is blurred or disappears, the sieve plate is small, the artery is thinner. The venous stenosis is curved, and there is a white sheath around the blood vessel, which is neuridiaatrophy. It can be caused by a variety of reasons, such as ischemia, inflammation, compression, trauma and demyelinating diseases.
Cause
Cause
First, it can be caused by a variety of reasons, such as ischemia, inflammation, oppression, trauma and demyelinating diseases. The causes of illness in children are more complicated:
1. Chromosomal abnormality is called cat syndrome, and the long arm part of chromosome 18 is missing.
2. Fatty disease Tay-sachs disease, Sandhoffs disease, lactosyl (neuro) sphingosine poisoning, NIEMANN-Pieck disease, --lipoproteinemia (Bassen-kornzwig syndrome).
3. Mucopolysaccharidosis Hurlers mucopolysaccharidosis, with cystineuria.
Second, the causes of optic atrophy are many, optic nerve diseases such as inflammation, metamorphosis, ischemia, trauma and tumor compression can cause optic atrophy, but sometimes it is difficult to find the cause of optic atrophy clinically. Common reasons are:
1. Retinal ganglion cells or nerve fiber damage such as retinitis pigmentosa, severe chorioretinal degeneration, inflammation and atrophy.
2. Optic nerve demyelinating diseases such as multiple sclerosis, disseminated sclerosis and optic neuromyelitis.
3. Inflammation such as optic neuritis, meningitis, encephalitis, brain abscess and sepsis.
4. Ischemic diseases such as central retinal artery occlusion, insufficient internal carotid artery or obstruction, arteriosclerosis, hypertension, giant cell arteritis, lupus erythematosus, massive blood loss, and low intraocular pressure glaucoma.
5. Optic disc edema.
6. Toxic damage to poisoning and nutritional disorders such as arsenic, lead, methanol, quinine, ethambutol and tobacco, as well as vitamin B deficiency such as severe malnutrition, vitamin B1 deficiency and pernicious anemia.
7. Compression such as intracranial, intraorbital tumor or hemangioma compression, especially the pituitary tumor compression of the optic chiasm is one of the most common causes of optic atrophy. In addition, bone hyperplasia such as Paget's disease, Crouzon's disease of craniosynostosis, and optic nerve compression caused by fragments of optic canal fracture caused by trauma.
8. Hereditary diseases such as Leber disease, Behr syndrome, mucopolysaccharide storage disease and lipid deposition.
9. A tumor, such as a primary or metastatic tumor of the optic nerve.
10. Late syphilis syphilis such as spinal tuberculosis and paralytic dementia.
11. Direct injury to the optic nerve of the trauma, such as contusion or avulsion of the optic nerve.
12. Glaucoma.
Examine
an examination
Related inspection
Optic nerve examination and CT examination of the temporal region
The clinical symptoms are mainly as follows: the optic disc is gray or white, or sallow, the boundary is blurred, the arterial blood vessels become thinner, the vein is normal or slightly thin, and the sieve plate can also be hidden due to the exudate and organic matter after the optic disc inflammation. Clearly, there are often white lines along the blood vessels near the optic disc. The visual field can be enlarged and the central dark spots and peripheral parts are reduced. The ginger shrinks from the temporal side, the visual acuity is significantly reduced, or even completely blind, bringing great results to the patients. pain. It also manifests as degeneration and disappearance of optic nerve fibers, conduction dysfunction, visual field changes, loss of vision and loss. Generally divided into primary and secondary, acupuncture mainly treats secondary optic atrophy caused by primary and inflammation.
In addition to the above symptoms, the fundus examination can still see the color of the optic papilla is pale yellow or pale, the boundary is blurred, the physiological depression disappears, and the blood vessels become thinner. The disease can only be diagnosed based on the gray or pale gaze of the eye. It must be combined with visual function tests to diagnose. Since the disease can be caused by a variety of causes, it is necessary to make an etiological diagnosis as much as possible. First, the possibility of intracranial space-occupying lesions should be excluded, supplemented by cranial X-ray examination, etc., which can be routinely included, and other head CT and MRI are also selectively used.
Diagnosis
Differential diagnosis
Differential diagnosis of secondary optic atrophy:
1. Secondary optic nerve atrophy caused by intracranial hypertension.
2. Intracranial inflammation, more common in tuberculous meningitis or optic arachnoiditis.
3. Retinopathy.
(1) vascular, central retinal artery or vein obstruction, arteriosclerosis of the optic nerve itself, normal nutritional vascular disorders, bleeding (digestive tract and uterus, etc.).
(2) inflammation.
(3) Glaucoma.
(4) Retinitis pigmentosa.
(5) Refsum disease (6) Black Mongolian familial dementia:
4. Optic neuritis and optic neuropathy.
(1) vascular, such as ischemic optic neuropathy.
(2) Demyelinating disease.
(3) Vitamin deficiency.
(4) Poisoning due to lead or other metals.
(5) Herpes zoster.
(6) syphilis.
5. Oppressive tumors, including meningioma, craniopharyngioma, pituitary adenoma, aneurysm (anterior communicating aneurysm) bone disease, including Paget's disease, deformity osteitis, skull stenosis and other ankle tumors. Trauma 7. Metabolic diseases such as diabetes, gangliosides, etc. 8. Hereditary diseases Leber disease, cerebellar ataxia, peripheral neuropathy such as Chareot-Marie-Tooth disease 9. Nutritional optic atrophy 10. Miscellaneous .
