Optic Atrophy Disease

BASICS

DESCRIPTION

End result of loss of ganglion cells or axons of the optic nerve

System(s) affected: Nervous
Genetics: Inherited forms may be autosomally recessive, autosomally dominant or X-linked recessive
Incidence/Prevalence in USA: Unknown
Predominant age:
- Inherited forms occur shortly after birth to the third decade
- Acquired forms tend to occur later
Predominant sex: Male > Female (inherited forms)

SIGNS AND SYMPTOMS

Loss of visual acuity
Pallor of the optic disk
Loss of pupillary reactions
Visual field defects

CAUSES

Glaucoma
Post central retinal artery or vein occlusion
Ischemic optic neuropathy
Chronic optic neuritis
Chronic papilledema
Compression of the optic nerve, chiasm, or tract by tumor or aneurysm
Trauma
Syphilis
Retinal degeneration (e.g., retinitis pigmentosa)
Congenital optic atrophy
Radiation neuropathy
Drugs (amiodarone, chloroquine, ethambutol, oral contraceptives, streptomycin, vincristine)
Thiamine deficiency

RISK FACTORS

Hereditary
- Family history
Acquired
- Diabetes mellitus
- Hypertension
- Radiation exposure
- Alcoholism
- Renal failure
- Arteriosclerosis

DIAGNOSIS

LABORATORY

CBC
Antinuclear antibody (ANA)
ESR
Rapid plasma reagin (RPR)
Fluorescent treponemal antibody absorption (FTA-ABS)
Serological test for syphilis
Heavy metal screen

Drugs that may alter lab results: N/A
Disorders that may alter lab results: N/A

PATHOLOGICAL FINDINGS

N/A

SPECIAL TESTS

Automated visual field test (i.e., Humphrey)
Color vision testing

IMAGING

CT or MRI of head

DIAGNOSTIC PROCEDURES

Carotid Doppler (adult acquired optic atrophy)
Complete ophthalmologic exam including dilated evaluation of retina

TREATMENT

APPROPRIATE HEALTH CARE

Outpatient

GENERAL MEASURES

Treat underlying cause (rarely possible)
Discontinue causative drug if possible
If pressure against optic nerve is cause, neurosurgery to relieve it may help if done early

SURGICAL MEASURES

N/A

ACTIVITY

Fully active

DIET

No special diet

PATIENT EDUCATION

Low vision counseling if bilateral
Genetic counseling if inherited
For patient education materials favorably reviewed on this topic, contact: National Eye Institute, Information Officer, Dept. of Health and Human Services, 9000 Rockville Pike, Bethesda, MD 20892, (301) 496-5248

FOLLOW UP

PREVENTION/AVOIDANCE

N/A

POSSIBLE COMPLICATIONS

N/A

EXPECTED COURSE AND PROGNOSIS

Rarely possible to treat the underlying cause effectively
Visual loss occurs over weeks to months
Optic atrophy secondary to vascular, trauma, degenerative changes, and some toxic causes has a very bad prognosis

MISCELLANEOUS

ASSOCIATED CONDITIONS

Inherited neurodegenerative conditions
- Hereditary ataxia
- Charcot-Marie-Tooth disease
- Storage diseases
- Leukodystrophies

AGE-RELATED FACTORS

Pediatric: Optic atrophy in small children is difficult to recognize because disks normally have a pale appearance
Geriatric: None
Others: None

PREGNANCY

None

OTHER NOTES

American Council of the Blind (800)424-8666

ABBREVIATIONS

N/A

Clinical Investigations

ROLE OF HOMOEOPATHY

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