Abstract
Nutritional deficiency may be the cause of a genuine optic neuropathy, sometimes associated
with involvement of the peripheral nervous system. Nutritional optic neuropathies
are usually bilateral, painless, chronic, insidious and slowly progressive. Most often,
they present as a non-specific retrobulbar optic neuropathy. The differential diagnosis
with other causes of optic nerve involvement, in particular of toxic origin, may be
particularly difficult. Nutritional deficits are often associated with toxic effects
from alcohol and tobacco; therefore, the separation of the nutritional and toxic components
is often illusory and artificial. The pathophysiological mechanisms involved in nutritional
– and toxic – optic neuropathies affect biochemical pathways involved in cell energetic
production, correction of oxidative stress and quenching of free radicals. The recognition
of these mechanisms could provide future therapeutic alternatives. Currently, the
treatment is limited to the intensive use of vitamins with variable results in individual
cases, and to the implementation of preventive measures, when feasible.
Keywords
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