Optic neuritis is a pathology that is inflammatory in nature and is characterized by damage to nerve fibers. Optic neuritis can involve tissue and nerve membranes in the lesion. As a rule, a symptom can appear at the development of neurological diseases in the body.(1)
What Are The Ways To Prevent Optic Neuritis?
Preventive measures are needed to exclude the possible occurrence of the disease. Consider the most basic recommendations: avoid head injuries; adhere to a healthy lifestyle, and exclude the use of alcohol in any doses; take vitamins to strengthen the immune system; be sure to follow the basic rules of hygiene; avoid diseases of an infectious nature; periodically get examined by a doctor.
If treatment is carried out promptly (in the initial stages of development), vision begins to recover a couple of weeks after the start of therapy. Sometimes the period of the temporary restoration of the visual system can be increased, based on the time of the start of treatment, as well as the neglect of the process. Complete restoration of vision is observed after several months.(6)
Etiology Of Optic Neuritis
With inflammation, compression of the mechanical fibers occurs, which entails failure in the supply of nutrients to them causing the death of these tissues.
The growth of connective tissue is observed in these areas, which leads to its gradual atrophy. Thus, if you do not start timely treatment (at its first manifestations), you can experience a gradual decrease in vision and subsequently, complete blindness may also occur.
The exact reasons why optic neuritis may occur is not yet known. Pathology occurs against the background of damage to the immune system of myelin, which covers nerve cells in the brain and spinal cord. Almost half of all patients with neuritis are subject to the development of sclerosis in the future.(2)
Symptoms Of Optic Neuritis
All symptoms of neuritis occur depending on the stage of the pathology. These include:
- Vision loss – this symptom is observed in the vast majority (more than 90%) of cases;
- The color sensation is impaired;
- Having pain in the area of the orbit, which intensifies when the eyeball moves;
- Visual phenomena arise – pointless images in the field of vision (spots, dots, shapes, lightning, elements usually shine or glow);
- Utkhoff syndrome – mental and neurological manifestations of demyelinating pathologies of the nervous system under the influence of certain factors (increased body temperature, hot environment).(3)
Diagnostic Methods For Optic Neuritis
To diagnose a disease such as neuritis of the oculomotor nerve, ophthalmoscopy, a study of color perception, and an analysis of the field of vision must be prescribed. Ophthalmoscopy will help to identify characteristic changes: swelling, redness, expansion of the optical disk, and blood vessels.
If there is an atypical course of the pathology, as well as if there is no effect from the treatment, computed tomography, magnetic resonance imaging of the head is performed. During an ophthalmological examination, the doctor determines the degree of expansion of the pupil and also detects the reaction of the eye to light (blinks or does not blink the eye in contact with light rays).(4)
How To Treat Optic Neuritis?
Treatment of optic neuritis begins immediately after a diagnosis is established. As a rule, patients with pathology are placed in a hospital to control the course of the disease during treatment.
Treatment consists of taking the following drugs:
- Antibiotics that help eliminate the infection
- Corticosteroids, anti-inflammatory drugs to slow the development of inflammation
- Diuretics, to control the edema of the nerves
- Drugs that improve microcirculation in the focus of inflammation
- Anti allergics, to help reduce the manifestations of the disease
The main treatment for patients with optic neuritis is corticosteroid therapy. Only such tools contribute to the inhibition of the destruction of the nerve membrane, as well as its recovery. At the initial stage of treatment, intravenous administration of the hormone is prescribed, over time moving to the tablet form of administration.
In rare cases, surgical treatment is recommended, namely decompression of the nerve sheath. During the operation, the doctor opens the sheath to reduce pressure on the nerve region, which is greatly increased due to inflammatory swelling.(5)
- Cadavid D, Balcer L, Galetta S, et al. Safety and efficacy of opicinumab in acute optic neuritis (RENEW): a randomised, placebo-controlled, phase 2 trial. The Lancet Neurology. 2017;16(3):189-199.
- Bennett JL. Optic Neuritis. CONTINUUM: Lifelong Learning in Neurology. 2019;25(5):1236-1264.
- Yoo YJ, Hwang J-M, Yang HK. Differences in pupillary light reflex between optic neuritis and ischemic optic neuropathy. PloS one. 2017;12(10).
- Yeshokumar AK, Banwell BL. Diagnostic Challenges in Pediatric Multiple Sclerosis and Neuromyelitis Optica Spectrum Disorder. Journal of Pediatric Neurology. 2018;16(03):185-191.
- Kale N. Optic neuritis as an early sign of multiple sclerosis. Eye and brain. 2016;8:195.
- Burton EV. Optic Neuritis: Clinical Manifestations, Pathophysiology, and Management. Neuroinflammation: Elsevier; 2018:337-353.
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