Optic Atrophy (OA)
In western medicine textbook the injured central nerves (including optic nerve) are not able to regenerate and cannot be repaired. Therefore clinicians in some country routinely tell patients there is no treatment. Clinicians in other country may prescribe vitamins, ATP or other supportive medicine.
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| Fig. 1. Optic atrophy( central white part) | Fig.2. Contracted visual field |
TCM treatment:
Based on previous clinical experiences, TCM treatments are effective for all kinds of OAs, including those due to high intraocular pressure (glaucomatous), due to tumor compression or radiation damage in the course of radiation therapy. TCM is also effective for ischemic and hereditary OAs. In this clinic about 2/3 of patients were glaucomatous. All of them got some vision increase from mild to significant. As to the radiation-caused OA, some patients may get vision increased in 1 week, normal in 3-5weeks. Some may not be that good, depending on the severity of the damage.
Obviously, there seems to be a big difference between TCM and Western medicine in terms of the treatment of OAs.
How does TCM make the vision better? Are the dead cells back to life again? No definite answer is available now. A preliminary explanation is presented as following.
The clinical diagnosis of OA is a result of clinicians’ subjective judgment based on objective examinations such as visual acuity, visual field, OCT etc. But none of those clinical tests can confirm the death of cells. The findings like decreased visual acuity, defect in visual field, and abnormal ONH symmetry only indicate some cells not functioning or accompanied by morphological changes. Lot of clinical practitioners believe all the non-functioning cells are dead, while, as a matter of fact, some of them may be not. Instead of dead, they are in a critical condition between death and life, which is referred to as parabiosis. Cells in parabiosis may resume their function when the environment changes favorably. It is presumed that at least partially by saving those parabiotic cells that TCM treatments render clinical effects on OAs.
Parabiosis is pathophysiologic concept and commonly encountered clinical phenomenon. As an example, when patients get heart failure due to myocardial infarction, the ECGs show a large area of myocardial necrosis, after a few days of treatment and life support the heart function recovered and the patients resumed their normal life. Are the dead myocardial cells alive again? A previous experiment may help explain. In 1960's, an animal experiment demonstrated that in the large infarction area only the cells in a small part were really dead. And in the other part the cells were in parabiosis. It was the functional recovery of these myocardial cells in parabiosis that makes the heart function improved ( from a magazine in Russian). Another example, in the past, all the necrotic tissue is to be removed from the burned area in surgeries. Now things have changed. In a surgery for a deeply burned hand, doctors saved some necrotic-like tissue that had been identified to be parabiotic. In this way, more tissue was saved and better functional recovery was achieved ( J. of TCM and Western combined surgery, 2008, April, 14;2). Actually, this is not new. Back to 50 years ago, Prof. Zhaote Li, a famous histologist at Beijing Medical University, had demonstrated the existence of parabiotic cells in burned necrotic tissue by use of histochemical technology. But for half a century most clinicians were unable to comprehend its importance. Now, more practitioners have understood the great clinical value of this concept. In addition, parabiosis may exist in any diseases including eye problems. Within Ophthalmology, beside OA, it may exist in other eye diseases like retinal degeneration, macular degeneration, and retinitis pigmentosa etc. the parabiotic cells bring a potential of vision increase to the patients, even though the eye examinations have indicated no possibility. That's why some eye diseases that have been announced no hope for any improvement by specialists, the vision increased to normal level after TCM treatments. Therefore, it is equally important to understand the concept of parabiosis for eye professionals, as well.