Pigment retinitis: symptoms, treatment
To date, many eye diseases are known. Some of them are of acquired character, while others are inherited and diagnosed almost from birth.
In the article we will talk about the disease, which belongs to the second group and is called "pigment retinitis".We will understand what causes provoke his appearance, and discuss whether there are effective ways to get rid of the problem.
What is pigmentary retinitis
The disease is a hereditary pathology of the retina, during which photodetectors and epithelium of the pigment layer develop dystrophic changes and form foci according to the type of bony bodies.
As a rule, pigmentary retinitis makes itself felt at an early age, when the child is not even 8 years old, and then begins to actively progress. It threatens the patient with blindness to 40-60 years.
Causes of the development of the disease
The main reason for the development of retinitis pigmentosa is the mutation of several genes that are responsible for the synthesis and exchange of specific proteins during intrauterine development.
In this case, the main ways of the development of the disease are identified:
- Correlated with sex. In this case, the pathology is transmitted from mother to son along with the X chromosome.
- Autosomal recessive. Pathology is transmitted to the child at the same time from two parents.
- Autosomal dominant. Pathology is transmitted from one of the parents of the child.
There are situations when retinitis pigmentosa is diagnosed in such patients whose family has not had the disease before. But such cases are rare. Usually, pathology is inherited and affects several generations of the family.
Children born in intimate relationship are especially at risk, when the probability of various gene mutations increases significantly.
Classification of pigment retinitis
Depending on the nature of the course of the disease and affected areas, two types of disease are distinguished:
1. Typical. With this form of visual acuity( both peripheral and central) for a long time remains within normal limits. Although at this point the defeat of the rod system and the appearance of foci of accumulation of pigment in certain areas of the fundus are already taking place.
2. Atypical. This form has several more varieties:
- Non-pigmented retinitis. During this species there are no pigment bodies on the fundus. At the same time, the rest of the symptomatology of the disease is observed.
- Sectoral horseshoe-shaped retinitis pigmentosa. The photo of the retina shows the presence of pigmented foci concentrated in any one part of the fundus and in combination in the form of a horseshoe. With this disease, symptoms may be completely absent or there is a very slow course.
- White spot. During this form, multiple white spots are observed on the fundus. Symptomatics at the same time as during pigment retinitis.
- Inverted. In this type of disease, the retinal lesion begins with its central part, affecting the cone system. The process is accompanied by the development of photophobia and rapid deterioration of central vision.
Signs of the disease
With a disease such as retinitis pigmentosa, the photo of the eyes obtained during ophthalmoscopy shows the presence of three characteristic features:
- Retinal pigment epithelial atrophy. In this case, narrowing of the smallest arteries and appearance of white pigment spots are observed.
- The disc of the optic nerve becomes noticeably paler.
- The so-called "bone bodies" appear along the periphery of the fundus and the course of small venous vessels.
Symptoms of the disease
What changes are accompanied by retinitis pigmentosa? Symptoms can be as follows:
- violation of twilight vision( "night blindness") as a result of dystrophic phenomena in the retina of the eye;
- intolerance to bright light;
- blurred vision;
- decreased peripheral vision;
- difficulty in accustoming the eyes to the dark room after the illuminated, and vice versa;
- niktalopia.
Atypical forms can additionally be accompanied by photophobia and reduced color vision.
Diagnosis of the disease
Diagnosis of pigment retinitis is performed by an ophthalmologist. This happens on the basis of an anamnesis, during which it is determined whether there was such a disease at least one of the next of kin. In addition, the study of the dynamics of photoreceptor cell loss by means of electroretinography and visual testing is carried out.
The presence of retinitis-specific pigmented foci can be identified through ophthalmoscopy and the photo taken from the fundus.
It is possible to detect the presence of defects in the fundus, as well as the presence of atrophy of pigment epithelium and edema in the area of the macula by carrying out fluorescent angiography of the retina( FAH).
In addition, color vision, dark adaptation and contrast sensitivity level are determined.
Treatment of pigment retinitis
Is it possible to get rid of such a disease as retinitis pigmentosa? Treatment, which is developed to date, unfortunately, is not able to completely rid of the problem. The only thing that physicians can help is to remove some symptoms of the disease.
In the presence of macular edema, diuretics are prescribed, including carbonic anhydrase inhibitors.
Lens clouding is removed by surgery.
For photocoagulation of blood vessels, doctors recommend the use of vascular pharmacological agents.
In addition, there is a vitamin therapy with an emphasis on nicotinic acid. There is also an opinion that the process of visual impairment can be slowed down by increasing the intake of vitamin A, which can be found in a variety of dietary supplements.
In addition, patients are advised to wear special dark glasses that will absorb solar shortwave radiation. This will help protect the retina from damage.
The above therapy will help to minimize the rate of progression of the disease, such as retinitis pigmentosa. Treatment with folk remedies in this case can be applied only in the form of compliance with a specially developed diet, which provides for a minimum amount of purine compounds and cholesterol in food. In addition, it is desirable to include blueberries in your diet, as it is a natural antioxidant and a source of vitamin A.
Another way to get rid of a problem like pigment retinitis is stem cell therapy. This method is now in active development, but scientists promise that in the future it will begin to be actively practiced and applied in combination with other components of therapy.
The principle of this type of treatment will be as follows. From stem cells with a healthy gene in special laboratories will begin to grow retinal cells. Next they will be implanted with patients with pigment retinitis for the return of their vision. In this case, the immune system does not in any case reject the implant, since it will be made from the patient's stem cells.
Although until the moment when this method starts to be used in the treatment of eye diseases, it is still far, today the first steps have already been taken to achieve the cherished goal.
Methods of preventing the development of the disease
Since pigmental retinitis occurs in most cases at the gene level, unfortunately, it will not be possible to avoid its manifestation. The only thing that a patient can do in such a situation is to slow down the process of development of the problem as much as possible and delay the onset of blindness.
For this it is important to register with an ophthalmologist, regularly visit him and listen to all the recommendations. Do not give up wearing special goggles that will protect the retina from the negative effects of bright light.
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