Optic Atrophy

Definition

Definition of Optic Atrophy
Optic atrophy is the term used to describe the loss of a proportion of optic disc nerve fibres. It is an important sign of advanced optic nerve disease. It is said to be primary if it occurs without any preceding optic nerve head oedema and secondary if it is preceded by oedema. It may also be described according to the underlying aetiology (i.e. whether this relates to primary disease of the retina or whether the problem originates at the level of the optic nerve).

There is also a rare autosomal dominant condition, optic atrophy 1 (also known as juvenile optic atrophy or Kjer-type optic atrophy) characterised by an insidious onset of visual impairment in early childhood with moderate-to-severe loss of visual acuity, temporal optic disc pallor, colour vision deficits and centrocecal scotoma of variable density.

Symptoms

Symptoms of Optic Atrophy
There will be a loss of vision which may be central or peripheral depending on the underlying condition. There may also be a degree of colour vision impairment, particularly in Kjer-type optic atrophy where blue-yellow dyschromatopsia is noted.

Causes

Causes of Optic Atrophy
The optic nerve is composed of nerve fibers that transmit impulses to the brain. In the case of optic atrophy, something is interfering with the optic nerve’s ability to transmit these impulses. The interference can be caused by numerous factors, including:

1. Glaucoma
2. Stroke of the optic nerve, known as anterior ischemic optic neuropathy
3. A tumor that is pressing on the optic nerve
4. Optic neuritis, an inflammation (swelling) of the optic nerve secondary to multiple sclerosis
5. A hereditary condition in which the person experiences loss of vision first in one eye, and then in the other (known as Leber’s hereditary optic neuropathy)
6. Improper formation of the optic nerve, which is a congenital problem (the person is born with it)

Diagnosis

Diagnosis of Optic Atrophy

1. It’s important to see your ophthalmologist if you experience any problems with your vision, especially those listed above.
2. If your ophthalmologist suspects optic atrophy, he or she will examine your eyes with an instrument called an ophthalmoscope. The doctor will look at the optic disc, the point at the back of the eye where the optic nerve enters. In optic atrophy, the optic disc will be pale because of a change in the flow in the blood vessels.

The ophthalmologist may also perform other tests to measure your vision and peripheral and color vision. If the ophthalmologist suspects a tumor or multiple sclerosis, you may undergo a magnetic resonance imaging (MRI) test.

Treatment

Treatment of Optic Atrophy
There is no real cure or treatment for optic atrophy. Therefore, it’s important to have regular eye exams (especially if you have a family history of eye diseases), and to see your ophthalmologist immediately if you have any changes in your vision.

Prognosis

Prognosis of Optic Atrophy
Optic atrophy is irreversible and treatment - where available - will be aimed at limiting its progression. The optic atrophy related to optic neuritis may, in some cases, be limited somewhat by the judicious use of steroids. Such patients should be under joint neurological and ophthalmological care.

Prevention

Prevention of Optic Atrophy
Certain conditions such as glaucoma and optic disc atrophy secondary to toxic, alcohol, tobacco and nutritional retinopathies can be limited by optimal management of the underlying problem.