METABOLIC AND MICROCIRCULATORY DISORDERS IN ISCHEMIC OPTIC NEUROPATHY

Аннотация

The blockage can occur with inflammation of the arteries (the arteritic form, usually associated with a disease called giant cell arteritis) or without inflammation of the arteries (the non-arteritic form). The only permanent symptom is painless vision loss, which usually comes on suddenly. Doctors make the diagnosis based on a person's symptoms and by examining the patient's eye with an ophthalmoscope. Blood tests and sometimes a biopsy of temporal artery tissue are used to diagnose giant cell arteritis. Treatment for the arteritis type does not restore vision, but it can help protect the healthy eye. Keywords: Causes, Symptoms, Diagnosis, Treatment, Prognosis. Introduction: Occlusion of a blood vessel that supplies blood to the optic nerve within the eye can lead to optic nerve dysfunction and vision loss. There are two types of arterial occlusion: arteritic and non-arteritic. Non-arteritic ischemic optic neuropathy is more common and usually affects people 50 years of age and older. Vision loss is usually not as severe as arteritic ischemic optic neuropathy. Risk factors include anatomical swelling of the optic nerve (certain features of the optic nerve that a doctor can see with an ophthalmoscope), high blood pressure, smoking, diabetes, and atherosclerosis. Other risk factors include obstructive sleep apnea, taking certain medications (such as amiodarone and possibly phosphodiesterase inhibitors, such as sildenafil, which is used to treat erectile dysfunction), a tendency to form blood clots, and low blood pressure at night. Arteritic ischemic optic neuropathy usually affects people over the age of 60. Inflammation of the arteries (arteritis), primarily due to giant cell arteritis, blocks blood flow to the optic nerve. Vision loss usually occurs quickly (within minutes, hours, or sometimes days) but is painless. In nonarteritic ischemic optic neuropathy, vision is usually impaired in one eye. In arterial ischemic optic neuropathy, the impairment can affect both eyes. Vision in the affected eye or eyes can range from almost normal to complete blindness. People with giant cell arteritis (usually adults) may have significant vision loss. They may have pain in the lower jaw when chewing or combing their hair, headaches, muscle pain, and scalp pain. 445 NEW RENAISSANCE 2025 MARCH INTERNATIONAL SCIENTIFIC AND PRACTICAL CONFERENCE VOLUME 2 | ISSUE 3 Research methods and materials: In the diagnosis, the fundus of the eye is examined using a magnifying lens (ophthalmoscope) using a lamp and a visual field test is performed to assess the degree of loss of central or peripheral vision. The optic nerve head in the fundus (the optic disc appears swollen). When determining the cause, it is determined whether the person has diseases called risk factors. If giant cell arteritis is suspected, blood tests are ordered and treatment with corticosteroids is started immediately to prevent further vision loss. A sample of tissue (biopsy) from the temporal artery may be taken to confirm the diagnosis and examined under a microscope. Blood tests measure the erythrocyte sedimentation rate (ESR), C-reactive protein levels, and levels of certain types of blood cells (complete blood count). The results of these tests may indicate the presence of inflammation, which is a characteristic feature of giant cell arteritis. If there are no signs of giant cell arteritis, a magnetic resonance imaging (MRI) or computed tomography (CT) scan of the brain may be done to make sure that the optic nerve is not being compressed by a tumor. Results: Depending on the suspected cause, other tests and investigations may be needed. For example, if a person has symptoms of obstructive sleep apnea (such as daytime sleepiness or snoring), a polysomnogram may be performed. If a person has blood clots, blood tests may be done to check for bleeding disorders. In non-arteritic ischemic optic neuropathy - controlling risk factors for atherosclerosis For arteritic ischemic optic neuropathy due to giant cell arteritis - corticosteroids and tocilizumab 446 NEW RENAISSANCE 2025 MARCH INTERNATIONAL SCIENTIFIC AND PRACTICAL CONFERENCE VOLUME 2 | ISSUE 3 Treatment is not effective in restoring vision in people with nonarteritic ischemic optic neuropathy. Treatment includes reducing risk factors for atherosclerosis, including controlling blood pressure and diabetes. Treatment of other conditions that cause nonarteritic ischemic optic neuropathy, such as bleeding disorders and obstructive sleep apnea, may also be required. To prevent vision loss in the other eye, people with arteritic ischemic optic neuropathy due to giant cell arteritis are given high doses of oral and/or intravenous corticosteroids as soon as possible. Adding tocilizumab (a drug that reduces inflammation) to corticosteroids has recently been shown to help people with giant cell arteritis. People with vision loss may benefit from magnifying glasses, magnifying glasses, and talking watches (low vision