Eye diseases. The concept of atrophy and glioma of the optic nerve (the most important)

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Eye diseases. The concept of atrophy and glioma of the optic nerve (the most important)

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36. The concept of atrophy and glioma of the optic nerve

The disease occurs as a result of an inflammatory or congestive process in the optic nerve, accompanied by a progressive decrease in visual acuity and a characteristic picture of the fundus (blanching of the optic nerve head, vasoconstriction).

With primary atrophy of the optic nerve, the borders of the disc are clear, and with secondary indistinct. Secondary atrophy of the optic nerve is observed after papillitis or congestive nipple, primary after retrobulbar neuritis, optochiasmal arachnoiditis, with spinal tabes.

In addition, secondary atrophy of the optic nerve can occur as a result of many diseases of the retina of an inflammatory, dystrophic and post-traumatic nature, as well as angiocirculatory disorders. Possible congenital atrophy of the optic nerve.

Treatment. Means aimed at improving blood circulation and stimulating the remaining depressed nerve fibers (nicotinic acid injections, oxygen under the conjunctiva, vitamins B1, B12, B6, tissue therapy, intravenous glucose, glutamic acid, ultrasound treatment, cysteine iontophoresis, etc.). Unfortunately, such therapy is not always effective, since the process is irreversible.

optic nerve glioma

Glioma is a primary tumor of the optic nerve. It occurs rarely and only in preschool children. The disease is characterized by three main features:

1) slowly increasing unilateral exophthalmos;

2) decreased visual acuity;

3) a picture of a stagnant disc in the fundus.

The leading symptom is an irreducible (not decreasing with pressure on the eyeball) exophthalmos, which does not change with head tilt, tension, crying. The protrusion of the eye is, as a rule, straight forward, and only sometimes there is a slight outward deviation, which is due to the localization of the tumor of the optic nerve in the region of the muscular funnel.

The tumor may spread along the optic nerve into the skull, and then there may be no exophthalmos. In such cases, X-ray examination helps to diagnose.

Glioma should be differentiated from exophthalmos in thyrotoxicosis, orbital angioma, and cerebral hernia.

The diagnosis is helped by such studies as radiography of the orbit, skull, optic nerve canal, angiography. Radioisotope diagnostics helps to exclude a malignant process in the orbit. What is important in determining the further tactics of the patient.

Author: Shilnikov L.V.

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