Stagnant optic disc: causes and treatment of the disease

In ophthalmology there are many side pathologies affecting the visual functions of a person. These include, for example, a disease called "congestive optic nerve disc" in medicine. In itself, it is not associated with eye diseases. But ophthalmologists often face this pathology due to the fact that it affects the state of the organs of vision.How to treat a congestive optic disc?

Definition of disease

The disc of the optic nerve is the area through which the nerves of the retina go out.From the anatomical point of view, this part has a funnel-shaped structure and was initially called the "nipple" of the optic nerve. Then, ophthalmologists began to call this area a "disk" because of the characteristic shape.

In addition, in ophthalmology, another name for this disease is used - a "blind spot".This name arose in connection with the fact that in this place there are no retinal cells, and when light photons hit it, no visual image formation takes place. The same circumstance makes diagnosis difficult: the patient does not feel any changes. Against the background of normal condition the disease progresses and makes itself felt only when there is a sharp violation of vision.

Causes

The main cause of congestion of the optic nerve is the increase in intracranial pressure.And what processes in the body lead to an increase in intracranial pressure? These include:

• Tumor processes in the cranial cavity;
• Edema of the brain;
• Inflammation of the brain tissue or its membranes;
• Craniocerebral trauma.

In addition, the edema of the optic nerve can lead to:

• Diseases of the blood;
• Allergic diseases;
• Arterial hypertension;
• Kidney disease.

Occasionally, the appearance of oedemas of the optic nerve is associated with eye and eye injuries or with diseases of the organ of vision, which are accompanied by a decrease in intraocular pressure. This state also develops when the outflow of fluid from the part of the optic nerve located in the orbit is disturbed. Normally, the intraocular fluid must flow into the cranial cavity, and a decrease in intraocular pressure may cause water retention.

Symptoms

With this disease, the state of the visual function remains in the normal state for a long time.Prolonged stasis provokes an atrophic process associated with increased pressure on the fibers of the optic nerve tissue.With the development of atrophy, the nervous tissue begins to be gradually replaced by a connective tissue with an irreversible loss of its functions.

The development of the examined disease goes through the following stages:

1. The initial stage is called the initial congestive disk of the optic nerve.During this period only edema of the disk occurs. When diagnosed on the fundus, the blurriness of the disc's boundaries, which starts from its upper edge, is visible. Hyperemia of the disc is moderate.
2. The second stage is marked stasis of the optic disc.At this stage, the entire disk swells, while the recess in its center is leveled, and the surface of the disc is bent to the vitreous body. The redness of the disc increases, acquiring a bluish tinge, the vessels and veins of the fundus widen, as if climbing on the convex disk of the optic nerve. Occasionally, around the edema disc, there are spotted hemorrhages. The visual functions at this stage are still normal, the patient is only concerned about headaches or no complaints at all. In the first two stages, when the cause of stagnation (the underlying disease) is eliminated, the edema gradually decreases, and the borders of the optic nerve disk are completely restored.
3. The next stage of development is a pronounced stagnant disk of the optic nerve.At this stage, the surface of the disc protrudes even more into the vitreous, creating multiple foci of hemorrhages on the disc itself and on the retina. The process of edema of the retina begins, compressing the nerve fibers of the optic nerve. Fibers perish, replaced by a connective tissue.
4. At the last stage, atrophy of the stagnant disc is noted.At the same time, secondary atrophy occurs in the optic nerve. Reduces edema of the disc and its size, narrowing the veins, gradually dissolving hemorrhages. The patient's condition is characterized by an improvement in the picture on the fundus and a sharp decrease in the function of vision. Next comes the complete and final atrophy of the optic nerves, and the functions of vision irretrievably go out.

Possible complications

The lack of timely treatment of stagnant phenomena in the optical nerve disc and the reasons that led to this, is fraught with the development of serious complications.The most dangerous is the secondary atrophy of the optic nerve. Clinically, this is manifested by loss of vision (at first partial, and then complete).

If the disease is not detected in time and not treated, the patient will lose sight forever and remain forever blind.

Treatment

With congestive optic nerve drive, treatment is aimed at eliminating the cause of hydrocephalus.Only at the last stages, the use of symptomatic agents is possible.But their effectiveness is rather questionable and very much depends on the therapy of the underlying pathology.

The result of treating the swelling of the optic nerve depends on how soon the treatment was started. And this means that the competent early diagnosis becomes important here.

Measures of primary diagnosis:

• Ophthalmoscopy, study of visual fields. These measures are simple in execution and allow you to suspect pathology in the early stages.
• Inspection of the fundus reveals the tortuosity of the vessels, the "expansion" of the blind spot and hemorrhage into the retina.The study of vision reveals the presence of livestock, that is, the loss of areas of visual fields.The more their area is larger, the processes of stagnation and nerve dystrophy are more significant.

Specialized diagnostic methods:

• Measurement of intraocular pressure. This allows you to indirectly judge the state of intracranial fluid.
• Diagnosis of intracranial pathologies(it is carried out by means of tomography methods: MRI and CT).
• Consultations with a neurologist and a neurosurgeon(required).

Medical way

Treatment of this disease is usually not an ophthalmologist, but a neurologist or a neurosurgeon, since most of the reasons for the stagnation of the optic nerve are neurological disorders.

Concurrently, the pathogenetic and symptomatic therapy, including:

• Dehydration, which reduces the severity of edema;
• Osmoterapiyu, pursuing the same goal;
• Vasodilator drugs(maintain normal microcirculation in the optic nerve, preventing its atrophy);
• Metabolic drugs(designed to maintain optimal metabolism in the fibers of the optic nerve).

The last two directions are aimed at preventing atrophic processes of the optic nerve.

Surgical intervention

With neoplasms in the cranial cavity, a surgical operation is shown - removal of the tumor.

After eliminating the cause of congestion of the optic nerve discs, if the disc atrophy has not yet developed,The picture of the fundus is normalized in the period from 2-3 weeks to 1-2 months.

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Prevention

Prophylaxis of a congestive optic nerve disc consists of the following measures:

• Regular supervision by an ophthalmologist;
• Prevention of traumatic brain injury;
• Timely consultation with a neurologist with the appearance of the slightest complaints.

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conclusions

Stagnation in the optic nerve disk is always a secondary condition in relation to the underlying pathological process. Elimination of the cause with the help of medical measures leads to the restoration of the normal structure of the optic disc. Symptomatic therapy is also conducted in parallel. Remember: the earlier the disease is detected, the more likely to be cured of this disease.

Also read about what is retinal rupture and macular degeneration.