Optic atrophy involves degeneration of optic nerve fibers, leading to vision decline and visual field narrowing. It is classified as primary or secondary, with causes including tabes dorsalis, nerve compression, toxins, and prior optic neuritis.
Acupuncture treatment targets specific points around the eye, with needles retained for one hour. Early-stage patients may see partial or full vision restoration after multiple treatment courses, though advanced cases have less favorable outcomes.
Optic atrophy refers to the degeneration of optic nerve fibers caused by various factors. The main symptoms…
The condition manifests as a significant decrease in vision and narrowing of the visual field.
Optic atrophy can be classified into primary atrophy (involving only degeneration of nerve fibers) and secondary atrophy (commonly seen after optic neuritis, where, in addition to nerve fiber atrophy, there is connective tissue proliferation on the optic disc).
Primary optic atrophy is an early symptom of tabes dorsalis, with one-third of patients exhibiting optic atrophy. Retrobulbar neuritis is also a common cause. Additional causes include optic nerve injury due to skull fracture, tumor compression of the optic nerve (e.g., pituitary tumors), drug or toxic gas poisoning, nutritional disturbances, anemia, and central retinal artery occlusion. Secondary optic atrophy is commonly seen following optic neuritis, papilledema, or certain retinal and choroidal pathologies.
Key Diagnostic Points
Gradual or sudden decline in vision, possibly to the point of only light perception; narrowing of the visual field or hemianopia; color vision disturbance, with color blindness first affecting green and then red; in advanced stages, dilated pupils.
**Funduscopic Examination:** In primary optic atrophy, the optic disc appears white, gray-white, or blue-white, slightly smaller than normal, with a prominent physiological cup and a clearly visible lamina cribrosa. The disc margins are distinct and regular, but the small vessels on the disc surface are absent. The peripapillary retina is normal, and the retinal vessels are generally normal, although the arteries may occasionally be slightly narrowed. In secondary optic atrophy, the optic disc shows a dense white or gray color with indistinct, irregular margins. The disc surface is covered by connective tissue formed from exudates, obscuring the lamina cribrosa and the small vessels on the disc. The retinal arteries are narrowed, while the veins appear normal or slightly tortuous and thin; occasionally, white lines formed by connective tissue encircle the vessel walls.
【Treatment】
I. Acupoints and Needling Techniques
1. BL1 (Jingming, affected side): Located on the face, in the depression slightly superior to the inner canthus. Use a gauge 30, 1.5 cun filiform needle. Perform routine local disinfection. Gently press the eyeball outward, then insert perpendicularly approximately 1.4 cun. (This point is prone to bleeding; do not rotate the needle. When withdrawing, apply slight pressure to the puncture site.) Needle sensation: distension and pain around the eye and the eyeball.
2. Shangming (affected side): Located directly below Yuyao (EX-HN4), between the supraorbital margin and the eyeball. Use a 30 mm needle.
Use a 1.5 cun filiform needle. Perform routine local disinfection. Gently press the eyeball slightly downward, then insert the needle perpendicularly to a depth of approximately 1.4 cun. Needle sensation: distension and heaviness within the eyeball.
3. **Taiyang (EX-HN5)** (affected side): Located approximately 1 *cun* posterior to the midpoint between the lateral end of the eyebrow and the outer canthus of the eye. A 30-gauge, 1.5 *cun* filiform needle is used. After routine local disinfection, insert the needle at a 75° angle obliquely posterior and inferior until reaching the bone. Needle sensation: distending sensation radiating to the posterior part of the eyeball.
4. Yiming (EX-HN14) (affected side): located 1 cun posterior to TE17 (Yifeng) in a parallel line. Use a 30-gauge, 2-cun filiform needle. After routine local disinfection, insert perpendicularly about 1.6 cun. Needling sensation: local distension and pain.
II. Methods
Select the affected side. The patient assumes a sitting position. Insert the needles into the above points (acupoints) according to the proper method, retain for 1 hour, then remove the needles. During retention, twirl the needles once. Treatment is given once daily, with 10 sessions constituting one course. After completing the course, rest for 5 days before the next needling session.
Commentary
Optic atrophy is a clinically challenging condition. The above treatment method has shown relatively good efficacy for some patients in the early stages, but it requires a prolonged course of treatment, during which partial or most vision can generally be restored. For patients with a longer disease duration, the treatment may still have some effect, though it is less favorable compared to those treated in the early stage.