Abiotrophy of the retina group for physical education. How is retinitis pigmentosa treated? Possible symptoms of retinal dystrophies

Abiotrophy of the retina is a pathology of the organ of vision of a dystrophic nature, inherited, in which the retina of the eye is affected. First of all, the rod apparatus of the retina suffers. Over time, the cones are also affected. With this disease, the sharpness of vision decreases, sometimes a person completely loses the ability to see. Such damage to the work of the visual analyzer is not very common.

The disease can have several different inheritance patterns: autosomal dominant, autosomal recessive, and sex-dependent, in which the disorder is transmitted on the sex chromosome (X).

Causes of pathology of the retina

The retina (the peripheral part of the visual analyzer) incorporates two types of sensitive receptors (rods, cones), which got their name for their cylindrical and canonical shapes, respectively.

The consequence of disruption of the gene structures responsible for the correct performance of their function, providing blood and substances that are the source of energy for the inner cover of the eye, are pathological changes in its layers containing these rods and cones. There is a slowdown in the formation of new photosensitive cells, which reduces photosensitivity.

These changes start from the periphery of the retina, since the concentration of rods is located there. Over a period of time (10–15 years), these damages spread to the center of the retina.

The development of abiotrophy can begin in childhood. In the absence of proper treatment, by the age of twenty, a person loses the ability to see normally.

Symptoms and Diagnosis

• "Night blindness" (hemeralopia). Occurs as a result of damage to the rods of the retinal layer of the eye. With this symptom, patients with abiotrophy are poorly oriented in the evening and at night. This sign is one of the earliest manifestations of pathology.
• Rapid decrease in peripheral vision. This defect is associated with deformation of the cylindrical light-sensitive receptors of the inner shell of the eye in the direction from the periphery to the central part. The narrowing of the field of view is gradual. Ultimately, there comes a moment at which patients look at the surrounding space as if into a pipe (tunnel). Hence this phenomenon is called “tunnel vision”.
• Decreased sharpness of color and black-and-white perception. This happens in the later stages of the disease as a result of damage to the second type of photoreceptors, which have a canonical form, in the center of the retina. In the absence of proper and timely medical intervention and a sharp progression of abiotrophy, there is a possibility of the patient becoming completely blind.
• Rapid eye fatigue. During the course of the disease, there is a rapid fatigue of the organ of vision of the patient.
• Other symptoms.

Most of the listed symptoms of pathology, often, are more likely to appear at the age of 20–30 years.

Ophthalmologist and geneticist - these are the two main specialists who should examine and examine people with such a disease of the retinal part of the visual analyzer. When diagnosing abiotrophy of the retina of the visual analyzer, the ophthalmologist analyzes such indicators as visual acuity and parameters of the patient's field of view. The fundus of the eye is carefully checked, where specific changes in the retina are detected.

On the inner surface of the eyeball, the narrowing of the blood vessels that supply the retinal layer of the visual analyzer with blood, and the deformation of the color of the disk on the optic nerve, are clearly visible. An electroretinography is performed, with the help of which the functionality of the inner mesh layer of the organ of vision is assessed.

To diagnose the presence of the syndrome of "night blindness", a study of the patient's condition is carried out using special methods, when both the orientation of a person in a darkened space and dark adaptation are assessed.

If there is a suspicion of the heredity of abiotrophy, it is advisable to study the history of the direct relatives of the patient with a geneticist for the early detection of mutations in the genes characteristic of this disease.

Abiotrophy treatment

After passing all the examinations, therapy begins. The duration and complexity of treatment depend on the age of discovery and the stage of the disease. At the moment, at the present stage, unfortunately, there is no specific method of dealing with any form of abiotrophy of the organ of vision.

Most often, treatment comes down to improving the supply of the retina and blood circulation, which slows down the development of the disease, by taking special drugs, vitamin complexes.

In order to stop the loss of vision in patients, some modern methods of therapy are used, mainly physiotherapy methods (exposure using natural and artificially created natural factors), microsurgical and laser correction.

Complications

Abiotrophy of the inner retinal layer of the eye can have complications in the form of clouding of the lens (cataract), damage to the optic nerve (glaucoma), or complete loss of the patient's visual analyzer.

Prevention of abiotrophy

Since this disease is hereditary, as mentioned
above, prevention is not possible. But early diagnosis and timely intervention of specialists will slow down the progression of this pathology and alleviate some symptoms.

The diagnosis and therapy of this disease is carried out by specialists at the Doctor Nearby clinic, who carry out the necessary procedures using the most modern equipment and in comfortable conditions. There are wonderful specialists in her staff, who have been successfully working in the field of ophthalmology for a long time, to whom an appointment is being made.

Hereditary dystrophic pathology, in which there is a predominant damage to the rods of the retina. It is quite rare. The first mention of the symptoms of the disease appeared in medical literature in 1857. The manifestations of the disease were described by Donders under the name "retinitis pigmentosa". Further, it became known as "rod-cone dystrophy", since in this disease they are predominantly affected.

Subsequently, it was found that in the later stages of the development of the disease, damage to the cones also occurs. In the end, it was decided to use the more acceptable term "retinal pigment abiotrophy". It reflects the very essence of the disease in more detail.

The essence of retinal damage in pathology

The retina of the eye (retina, or photosensitive membrane) consists of two types of receptors: rods and cones, which got their names because of their unusual shape. predominantly located in the central zone of the retina. They provide not only high visual acuity, but also color vision. Rods, on the contrary, are scattered over the entire surface of the retina. Nevertheless, there are more of them on the periphery of the retina than in its central zone. The main function of the rods is to provide peripheral and twilight vision (visual acuity in low light conditions).

When certain genes that are responsible for the nutrition and functioning of the retina are damaged, its outer layer (the one on which the rods and cones are located) is gradually destroyed. The destruction of the retina begins at the periphery and gradually spreads to the central zone of the retina. This has been happening for several decades.

In most cases, both eyes are equally affected. The first symptoms of the disease can be detected already in childhood. Unfortunately, the disease progresses quite quickly and by the age of twenty the patient can completely lose his ability to work. But this is not the only flow option.

There are cases when only one eye or a separate sector of the retina is affected. Sometimes the pathological process begins at a later age. Patients suffering from retinal pigmentary abiotrophy are at increased risk of developing, early opacification, or development.

Symptoms of retinitis pigmentosa

Abiotrophy of the retina is manifested by the following symptoms:

• "Night blindness" or hemeralopia. It occurs due to the fact that damage to the rods of the retina occurs. Patients suffering from this disease can hardly navigate in twilight or low light conditions. The first manifestation of the disease is a violation of orientation in the dark. It may appear several years before the first manifestations visible on the retina.
• Progressive change. There is damage to the rods of the retina from the periphery to the center. Initially, the boundaries of peripheral vision will decrease insignificantly, and in the case of progression of the disease, it may come to a complete absence of peripheral vision. It is called tubular or tunnel vision. This happens when there is only a small island in the center of the retina that provides visual function.
• In the later stages of the disease, visual acuity and color perception decrease. This is due to the fact that at this stage of the development of the pathological process, cones in the central zone of the retina are affected. With the steady progression of the disease, complete loss of vision occurs.

Methods for diagnosing the disease

During the initial examination, visual acuity and peripheral vision are checked. Also, the doctor carefully examines. On it, depending on the severity of pathological changes, changes in the retina characteristic of this disease can be detected. These may be such manifestations of retinal abiotrophy as bone bodies (areas of dystrophic destruction of receptor cells), narrowing of the arterial vessels of the retina, and significant blanching of the optic nerve head.

To clarify the diagnosis, additional electrophysiological studies are carried out. With their help, you can most objectively assess the functionality of the retina. Special methods check the patient's ability to adapt to the dark and navigate in a dark room.

If there is a suspicion that there is pigmentary retinal abiotrophy or this diagnosis has already been established, then it is advisable to examine the direct relatives of the patient for the purpose of early diagnosis of the disease. This follows from the fact that retinal abiotrophy is a hereditarily determined disease.

Treatment of retinal pigment abiotrophy

Unfortunately, no specific treatment for retinitis pigmentosa has been found to date. You can stop the progression of the disease by taking vitamins, drugs that improve blood circulation and nutrition of the retina. A group of so-called "peptide bioregulators" is also used to treat the disease. They improve nutrition and reparative capabilities of the retina.

The technical capabilities of modern medicine are steadily increasing. Currently, there are new reports of a number of completely new experimental directions in medicine. They are developing a technique for the treatment of retinal pigment abiotrophy using genetic engineering, which allows you to restore damaged genes. Attempts have been made to introduce special electronic implants into the organ of vision, which act similarly to the retina of the eye and allow completely blind people to more or less freely navigate in space and serve themselves independently.

Moscow clinics

Below are the TOP-3 ophthalmological clinics in Moscow, where you can undergo the diagnosis and treatment of retinitis pigmentosa.

Pigmentary retinal degeneration (retinitis pigmentosa, abiotrophy) refers to genetically inherited diseases. Usually the process begins imperceptibly, can last for years and lead to complete blindness.

Causes and mechanism of the development of the disease

Treatment of retinitis pigmentosa

In the advanced stages of the disease, cataracts or glaucoma of secondary origin are formed. In this case, the central vision decreases sharply and quickly. Gradually, atrophy of the optic disc develops, which leads to reflex immobilization of the pupils. As for peripheral vision, it can be completely absent and then this condition is called tunnel vision (as if a person is looking through a long and thin tube).

Occasionally, atypical forms of retinal degeneration occur. In these cases, there may be only changes in the optic nerve head, narrowing and tortuosity of blood vessels, impaired twilight vision. Unilateral degeneration is extremely rare, and in almost all cases there is a cataract on the diseased eye.

Treatment of retinitis pigmentosa

The initial treatment for retinal degeneration most often consists of medications. Their main action is to improve metabolism in the retinal layer, restore the retina and dilate blood vessels.

For this purpose, appoint:

• Emoxipin;
• Mildronate;
• Emoxipin;
• Taufon;
• Nicotinic acid;
• No-shpu with papaverine;
• Aloe extract;
• Retinalamin;
• Alloplant.

These funds can be introduced into the body, both in the form of eye drops, and by injection. It is also advisable to use in the treatment of a complex of nucleic acids - Enkad, which significantly improves visual functions in more than half of the cases. It is prescribed intramuscularly, subconjunctivally, using iontophoresis, or local applications are made with it.

Often, in parallel with drug treatment, physiotherapeutic measures are also used, the purpose of which is to stimulate the regenerative processes in the retina and activate the remaining rods and cones. Electrostimulation of the eye and magnetic resonance therapy, ozone treatment are widely used. Vasoreconstructive operations can be used to restore the vascular bed.

Surgical treatment of retinitis pigmentosa is used to normalize the blood supply to the retina, for this purpose, some eye muscles are transplanted into the suprachoroidal space.

Recently, encouraging data has also come from genetic engineers who have found the ability to restore damaged genes responsible for the development of this disease. In addition, special implants have been developed - retinal substitutes.

And very recent experiments on mice, conducted in Britain, convincingly prove that blindness can be treated with the help of special light-sensitive cells, administered by injection. And although this technique has not yet been tested in humans, scientists hope that this drug can be used to treat people suffering from retinitis pigmentosa.

As for the prognosis of the disease, in general it is unfavorable, but with early detection of pathology and timely initiation of treatment, the process can be delayed and even improved. All patients are advised to avoid prolonged stay in dark rooms, not to engage in heavy physical labor.

In the practice of "UnicaMed" there are already several people who came to the clinic with pigmentary degeneration of the retina at the stage of "non-vision" and disability, after the sessions they restored their vision and have maintained it for several years now.

However, first things first. Let's get acquainted with one case history:

Yana, teacher, charming mother of 9-year-old daughter Olechka.

2011. Yana is 27 years old, and she is rapidly losing her sight. Twilight becomes an insurmountable test for a woman: all objects lose their shape and merge.

During the day, she still sees quite well, but the world has narrowed to a tunnel: Yana sees light, color and movement only in front of her; right and left - darkness. It is impossible to drive a car in such a state, and this is a disaster for a single working mother. The doctor makes a diagnosis of pigmented retinal abiotrophy. And he adds: medicine cannot cure this disease, the prognosis is a complete loss of vision in both eyes. There is no time for self-pity, you need to act: a will, Olya's transfer from a French school to a school in the yard, her mother moves from Omsk to a Moscow apartment. Unsuccessful treatment begins with a forum and a search for folk remedies. Then - a series of injections of ribonucleotides, but Yana will not be included in those 60% of the lucky ones who respond positively to the medicine.

Yana got to UnikaMed in 2012. She is 28 years old. With her right eye, without correction, she sees 35%, with her left eye - 45%. After correction with optics, the right eye - 45%, the left - 60%.

“For a few more years, no one in the world could give a positive answer to the question of whether there is a method for treating retinitis pigmentosa. Now our clinic successfully treats previously considered incurable eye diseases.

Regenerative therapy shows a positive effect in the treatment of retinitis pigmentosa in all patients. The pigment epithelium is restored, the blood supply and nutrition of the eye improves, visual acuity increases, the field of view expands, color returns.

The third session of regenerative therapy was held by Yana in September 2014. Result: the right eye without optics sees 60%, the left eye sees 95%. The fields of vision on the right and left have been restored, Yana is driving a car again.”

Marina Yurievna, chief physician of the UnikaMed clinic

How does pigmentary abiotrophy of the retina occur?

The visual cells responsible for our vision are rods and cones. These cells are filled with different pigments.

There is only one pigment in the sticks. Rods allow us to see in the dark. In bright light, they are responsible for the perception of blue colors. Cones contain several different visual pigments. Some pigments perceive green, others red, and still others yellow.

Different pigments react differently to light: this is how the brain receives information about the color and amount of light around. But as a result of a chemical reaction to light, the pigments themselves become discolored. Normally, the spent pigment is removed from the cells. The process of utilization of metabolic products is performed by the so-called pigment epithelium, which is located at the base of the rods and cones.

With tapetoretinal degeneration of the retina, the mechanism of utilization of visual pigments is disturbed, the pigment that is not sensitive to light and color accumulates, and the cells of vision cease to perform their function.

The rods are the first to suffer, so the disease used to be called rod - cone retinal dystrophy.

With tapetoretinal retinal dystrophy, classical medicine cannot yet offer an effective way to clean the pigment epithelium from pigment. Metabolic drugs are usually prescribed to improve nutrition and blood circulation in the pigment epithelium. But over time, the power of the gene begins to prevail over the capabilities of drugs, and blindness eventually progresses.

The method of regenerative therapy developed by the group allows for the successful treatment of retinitis pigmentosa: significantly improve vision and maintain it for a long time.

This is not done anywhere in the world: neither in the USA, nor in Israel, nor in Cuba, nor in other clinics in Russia.

“The ophthalmologist injects a specially prepared preparation based on the patient's own bone marrow cells into the problem areas of the eye. This drug subsequently starts the process regeneration (recovery) pigment epithelium of the eye.

If the treatment regimen is followed, the method of regenerative therapy not only improves vision and expands the field of view. Even with genetic diseases of the eye, it can extend the active period of vision for decades.”

How is retinitis pigmentosa treated?

Before prescribing treatment, the ophthalmologist conducts a detailed eye examination and confirms the diagnosis. This is a very important stage of treatment, as different diseases and even their different stages make adjustments in the procedure for preparing cells and in the procedure for their introduction.

Abiotrophy of the retina is a degeneration that has a pigmentary character. It can be a real ailment and be inherited. The main lesion will come to the rods, which are located in the retina.

Abiotrophy of the retina is a disease that is inherited

The disease is quite rare, but if it occurs, then blindness can also occur. It was first discovered in 1857. After the study, it became clear that damage to the genes that will be responsible for supplying your eye with blood can cause it.

Reasons for development

Two types of light-sensitive structures can be found on the retina. These include rods and cones, which have such a name because of their appearance. In most cases, the lesion can cover both eyes at once. Most patients by the age of 21 can lose their sight. Sometimes only one eye or a segmental zone can also be affected.

Vision test for abiotrophy

If this ailment begins to manifest itself in adulthood, then glaucoma or may develop. If pigmentary degeneration of the retina occurs, then a tumor with a malignant nature may occur. The tumor will grow rapidly and therefore surgery is necessary.

Modern medicine allows you to get rid of the problem in several stages. Many specialists fight the disease thanks to radiosurgical methods. Abiotrophy of the retina of the eye treatment with radio waves must be carried out carefully so as not to damage the cells of the eye.

Before treatment, it is necessary to perform modern diagnostics. If the disease has an initial stage, then it is much easier to get rid of it.

Symptoms of pigmentary degeneration

If you have retinal pigment abiotrophy, then remember that there will be characteristic signs for the disease:

1. Rapid development of hemeralopia. This symptom is also called "night blindness". This phenomenon can occur due to damage to the rods that are located on the retina. A similar symptom can also occur long before the appearance of retinal tapetoretinal abiotrophy.
2. The patient may begin to quickly deteriorate peripheral vision. This is usually due to progressive damage to the eyeballs.
3. At a later stage, a significant decrease in the acuity of black-and-white and color vision may occur. With a significant progression of the disease, a person can simply go blind.
4. The eyes begin to tire quickly.

Most of the symptoms that we have indicated can appear after 20-30 years. That is why if you notice the first signs, then you should perform a quick treatment.

Diagnostic technique

It can be difficult to diagnose in the early stages. It is possible to determine the presence of abiotrophy only after 6 years. It is during this period that the symptom of "night blindness" may occur. During the examination, specialists will check peripheral vision. Also, doctors will check the fundus, since it is on it that a change in the retina will be noticeable. Most of all, the bone bodies that affect the zones of dystrophic lesions will undergo changes.

For the diagnosis to be correct, it is also necessary to conduct an electrophysiological examination, which can provide completely objective data. Then the patient's ability to be in complete darkness will be checked. Only after collecting all the necessary data will a diagnosis be made.

Treatment

If you have retinitis pigmentosa, treatment in this case will be impossible. Today there is no method that would help get rid of this disease. To date, medicine can only slow down development through the use of special vitamins and medicines.

In addition to tablets, drops can also be used, which include "" and other regulators that will have a peptide base. Today, to combat such diseases, physiotherapeutic methods can also be used, which allow you to dramatically increase blood flow to the eyeball. If you want to carry out prevention at home, then you can also use. You can see these glasses in the photo below.

Sidorenko glasses for the prevention of abiotrophy at home

Medicine does not stand still and therefore there is no need to be upset. Doctors are constantly studying and applying new methods and therefore we hope that significant results can be seen in the near future. The techniques that were previously used were considered bad, since they could only delay development for a certain time. Now, thanks to the use of modern methods, it is possible not only to stop the disease, but also to achieve a significant improvement in vision.

During the procedure, remember that such a process is considered quite long and laborious. The entire treatment process must be carried out only under the attention of specialists. Physicians must have considerable experience in conducting such treatment.