Optic Atrophy Health Article

Prognosis

Many patients with optic neuritis eventually develop multiple sclerosis. Most patients have a gradual recovery of vision after a single episode of optic neuritis, even without treatment. Prognosis for visual improvement in Leber's hereditary optic neuropathy is poor, with the specific rate highly dependent on which mitochondrial DNA mutation is present. If the cause of toxic or nutritional deficiency optic neuropathy can be found and treated early, such as stopping smoking and taking vitamins in tobacco-alcohol amblyopia, vision generally returns to near normal over several months' time. However, visual loss is often permanent in cases of long-standing toxic or nutritional deficiency optic neuropathy.

Prevention

People noticing a decrease in vision (central and/or side vision) should ask their eye care practitioner for a check up. Patients should also go for regular vision exams. Patients should ask their doctor how often that should be, as certain conditons may warrant more frequent exams. Early detection of inflammations or other problems lessens the chance of developing optic atrophy.

As of mid 1998, there are no preventive measures that can definitely abort Leber's hereditary optic neuropathy in those genetically at risk, or in those at risk based on earlier involvement of one eye. However, some doctors recommend that their patients take vitamin C, vitamin E, coenzyme Q₁₀, or other antioxidants, and that they avoid the use of tobacco or alcohol. Patients should ask their doctors about the use of vitamins. Avoiding toxin exposure and nutritional deficiency should prevent toxic or nutritional deficiency optic neuropathy.

PERIODICALS

Cullom, M. E., et al. "Leber's Hereditary Optic Neuropathy Masquerading as Tobacco-Alcohol Amblyopia." Archives of Ophthalmology 111 (1993): 1482-5.

Funakawa, I., et al. "Cerebellar Ataxia in Patients with Leber's Hereditary Optic Neuropathy." Journal of Neurology 242(1995): 75-7.

Goldnick, K. C., and E. R. Schaible. "Folate-Responsive Optic Neuropathy." In Journal of Neuroophthalmology 14(1994):163-9.

Newman, N. J. "Optic Neuropathy." Neurology 46, no. 2 (1996): 315-22.

ORGANIZATIONS

American Academy of Neurology. 1080 Montreal Ave., St. Paul, MN 55116. (612) 695-1940. <http://www.aan.com>.

Prevent Blindness America. 500 East Remington Road, Schaumburg, IL 60173. (800) 331-2020. <http://www.preventblindness.org>.

Laurie Barclay, MD

KEY TERMS

Atrophy—A destruction or dying of cells, tissues, or organs.

Cerebellar—Involving the part of the brain (cerebellum), which controls walking, balance, and coordination.

Mitochondia—A structure in the cell responsible for producing energy. A defect in the DNA in the mitochondria is involved in Leber's optic neuropathy.

Neuritis—An inflammation of the nerves.

Neuropathy—A disturbance of the nerves, not caused by an inflammation. For example, the cause may be toxins, or unknown.