Optic Neuropathy (Atrophy)
by Drs. Like Wu, Xiaojuan Wang, Bo Cheng, Susan Chu and Shengjie Liu
Wu Medical Center, Bejing, China
Optic neuropathy refers to damage to the optic nerve due to any cause. Damage and death of these nerve cells, or neurons, leads to characteristic features of optic neuropathy. The main symptoms are loss of vision, field of vision centripetal narrowed, vision defect, hemianopsia, with colors appearing subtly washed out in the affected eye. On medical examination, the optic nerve head can be visualized by an ophthalmoscope. A pale disc is characteristic of long-standing optic neuropathy. In many cases, only one eye is affected and patients may not be aware of the loss of color vision until the doctor asks them to cover the healthy eye.
Optic neuropathy is often called optic atrophy, to describe the loss of some or most of the fibers of the optic nerve. In short, optic atrophy is the end result of any disease that damages nerve cells anywhere between the retinal ganglion cells and the lateral geniculate body (anterior visual system).
Causes
The optic neuropathy may be caused by any of the following:
• Ischemic optic neuropathy
• Optic neuritis
• Compressive optic neuropathy
• Infiltrative optic neuropathy
• Infiltrative optic neuropathy
• Traumatic optic neuropathy
• Mitochondrial optic neuropathies
• Nutritional optic neuropathies
• Toxic optic neuropathies
• Hereditary optic neuropathies
Treatment
As far as the treatment for optic nerve atrophy is concerned, we should first consider the incentives and then apply the treatment accordingly. For instance, for patients suffering optic nerve atrophy caused by pituitary tumor, they should undergo surgery to cut the tumor out. Optic canal fracture patients should receive treatment to remove the fracture and to release optic canal and the front end of dural sheath's middle part with decompression. Optic nerve inflammation patients should take some measures to resist inflammation and do some immune-regulation work. Once the patient develops optic nerve atrophy, it is almost impossible for him or her to heal. The purpose of early treatment is primarily to protect the remaining optic nerve cells and nerve fibers, and to maintain or even restore part of these cells' function.
However, previous treatment provides no effective way to treat sequela of optic nerve atrophy. There is no way to regenerate the lost optic nerve cells and nerve fibers.
In recent years, using stem cells technology (nerve regeneration technology) we have treated many patients who suffered from optic neuropathy or optic nerve atrophy. Almost all of them have had varying degrees of improvement after receiving treatment.
Neural stem cells are a kind of special cell. With certain positioning and adjusting technology, they will be localized to the accurate lesion part in visual photoreceptor cells, retina and optic nerve. After being positioned in the lesion part, they will differentiate into functional optic neurons, oligodendrocytes and astrocytes, which will increase the number and restoration of optic nerve cells as well as the optic nerve's regulation toward retina and visual photoreceptor cells.
The mesenchymal stem cells can differentiate into photoreceptor cells and immune-adjustment cells. The differentiated cells will first repair patients' autologous cells' synaptic nucleoprotein, and eventually play a positive role in treating lesion in retinal pigment cells and optic nerves.
For patients who suffer from optic nerve injuries or optic nerve atrophy, such a treatment will effectively supplement the missing optic nerve cells and increase the restoration of fibers, and eventually achieve the goal of improving patients' eyesight, field of vision and ability of color discrimination.