The term "retinal pigment degeneration" refers to a pathological process, the course of which is accompanied by a narrowing of the visual fields. The disease is hereditary. The danger of pathology lies in the fact that it can be asymptomatic for a long time. Meanwhile, irreversible changes occur in the body. The most common consequence is complete blindness. In this regard, if the first signs of retinal pigment degeneration occur, you should contact an ophthalmologist. The specialist will conduct diagnostic measures and draw up the most effective treatment for the disease. Currently, the progression of the disease can be stopped using both conservative and surgical methods.
Pathogenesis
Pathology can be transmitted both along the female and male lines. In the first case, it is customary to talk about mitochondrial pigment degeneration of the retina. Most often, the disease is transmitted from mother to daughter.
With retinal pigment degeneration, mitochondria are transmitted with the gamete cytoplasm. Their genetic characteristics are very unusual. Each mitochondria is represented by a double-stranded ring molecule. The latter contains 16569 base pairs. Mitochondrial DNA is absent in spermatozoa, which is why it can only be transmitted through the female line.
Less commonly, retinal pigment degeneration is diagnosed in men. In such cases, it is customary to say that the pathology is linked to the X chromosome.
According to the results of numerous studies, the presence of defective genes in humans does not mean that he will suffer from an ailment. The development of the pathological process starts only under the influence of some provoking factor.
At an early stage of the course of the disease, metabolic processes in the choroid and retina are disturbed. Against this background, the pigment layer is slowly being destroyed. Visual acuity does not decrease immediately. This is due to the fact that degenerative changes initially occur in remote areas of the retina. But over time, the central zone is also affected. At this stage, a person is already suffering from pronounced clinical manifestations of the disease.
Both one eye and both can be involved in the pathological process. Regardless of this, over time, both units of the visual system are affected. The disease develops very slowly. Complete disability occurs, as a rule, by 20 years.
In the International Classification of Diseases (ICD-10), retinal pigment degeneration is assigned the code H35.5.
Etiology
Pathology in all cases is hereditary. However, as mentioned above, the presence of defective genes is not a guarantee of the development of the disease.
The disease occurs only under the influence of any provoking factor. The role of the latter may be the following diseases and conditions:
- Increased blood pressure.
- Pathology of the vascular system.
- Increased blood sugar.
- Infectious diseases.
- The presence in the body of a large amount of "bad" cholesterol.
- Intoxication process.
- Diabetes.
- Overweight.
- Myopia.
- Smoking
- Frequent use of alcohol-containing drinks.
- Exposure to the eyes by ultraviolet rays.
- Unbalanced diet, predominance of fatty foods on the menu.
- Vitamin deficiency in the body.
- Staying long under stress.
Thus, the launch of the development of the pathological process can occur not only in the young, but also in old age. Persons with a hereditary predisposition should lead a healthy lifestyle and treat the identified diseases of the endocrine and cardiovascular systems in a timely manner. In addition, eye injury should be avoided.
Clinical manifestations
Retinal pigment degeneration in ophthalmology is one of the most dangerous diseases. This is due to the fact that at the initial stage of development of the disease is not accompanied by the appearance of severe symptoms. In most cases, patients go to the doctor only when they have all kinds of complications. The most common consequences of retinal pigment degeneration are glaucoma and cataracts.
The first alarming sign is a condition characterized by the presence of difficulties in orienting in low light conditions. It already indicates that there was a narrowing of the visual field.
"Night blindness" is a major alarming symptom. When it appears, you must immediately contact an ophthalmologist. Ignoring this symptom leads to the progression of the development of the disease. Over time, side vision disappears.
The advanced stage of the disease rarely proceeds without complications. At this stage, most patients have glaucoma and cataracts. Central vision begins to slowly lose sharpness. A logical consequence is blindness.
Diagnostics
If the first alarming signs occur, you need to contact an ophthalmologist. The specialist will conduct primary diagnostic measures, consisting in interviewing the patient and collecting an anamnesis.
In addition, the doctor’s task is to conduct an examination, including:
- Visual acuity test.
- Assessment of the fundus.
- Verification of peripheral vision.
Based on the results of the studies, the doctor indicates in the patient’s medical record the diagnosis “retinal pigment degeneration”, ICD-10 code, and also reflects the treatment regimen.
It is important to know that pathology is almost impossible to detect in children under the age of six. But in any case, the child should be shown to the doctor if he experiences difficulties while moving at dusk or in very dimly lit rooms.
Drug treatment
The disease requires an integrated approach. At the initial stage of the development of the disease, it is enough to take and drip the prescribed medications into the eyes. In severe cases, the doctor decides on the feasibility of surgical treatment of retinal pigment degeneration. The drugs most commonly prescribed by ophthalmologists are described in the table below.
| Name of facility | Impact | Dosage regimen |
| Aloe extract | The active component enhances visual acuity. In addition, aloe relieves fatigue in the eyes, and is also the prevention of a large number of concomitant ophthalmic diseases. | Three times a day, 1-2 drops. The drug is intended for adults and children over 12 years old. |
| "Emoksipin" | The drug belongs to the group of angioprotectors. The active component helps to reduce the permeability of the vascular wall. The drug has powerful retinoprotective properties. Against the background of treatment, microcirculation in the eyes improves, and hemorrhages also resolve. | Three times a day, 1-2 drops. In the presence of retinitis pigmentosa in both eyes, an injection is more often prescribed. The medicine is administered subconjunctively 1 time per day. |
| Taufon | This is a metabolic agent, the active substance of which stimulates the acceleration of the regeneration process in eye diseases of a dystrophic nature. | 2-4 times a day for 1-2 drops. The drug is contraindicated in persons under 18 years of age. |
| Mildronate | The drug restores the blood supply to the retina. In addition, against the background of treatment, the progression of pathology slows down or completely stops. | It is determined by a doctor. The daily dosage rarely exceeds 250 mg. |
| Enkad | This drug is prescribed to almost every patient with hereditary retinal pathologies. The active component helps to reduce the deficiency of nucleic acids in the body. | 210 mg of the drug 1 time per day (intramuscularly). |
| Retinalamine | The active substance helps to improve metabolism in the tissues of the eye. In addition, it stimulates the regenerative processes in the retina. | 5-10 mg once a day (intramuscularly or parabulbarno). |
| "A nicotinic acid" | The tool improves metabolism. | It is determined by a doctor. The daily dose should not exceed 0.5 g. |
| “No-Shpa with papaverine” | The drug is an antispasmodic. Against the background of treatment, the pressure in the walls of the vessels decreases. | Determined by a doctor |
It is important to understand that all funds must be prescribed by a doctor. The specialist is also entitled to make adjustments to the dosage regimen.
Other conservative treatments
In addition to drug therapy, ophthalmologists often prescribe the following procedures:
- Hardware photo stimulation. The basis of the operation of the devices is the following technique: during contact with tissues in certain areas of the eyeball, excitation occurs, which significantly slows down the progression of the disease. The radiation that is emitted by the device improves microcirculation and helps to normalize metabolism. In addition, using the device you can get rid of edema of the retina. Against the background of hardware treatment, retina also strengthens.
- Physiotherapy. It is prescribed to stimulate the processes of retinal regeneration. In addition, photoreceptors are activated during treatment. Currently, the most effective procedures are as follows: ozone therapy, stimulation with electric pulses, magnetic resonance therapy.
As a rule, the course of treatment consists of 7-10 procedures.
Surgical intervention
If conservative methods of therapy are ineffective or in severe cases, the doctor decides on the advisability of the operation.
The purpose of the surgery is to improve blood supply to tissues and stop the progression of retinal pigment degeneration. Currently, the most common is the technique, the essence of which is the transplantation of certain muscle tissues of the eye into the suprachoroid space. In addition, there are implants that surgeons implant during the operation. Artificial elements replace the damaged retina and perform all its functions.
Clinical studies are ongoing. The results of the latter indicate that scientists have found a way to restore defective genes, the presence of which significantly increases the risk of developing the disease.
In addition, the use of photosensitive cells should be a progress in the treatment of retinal pigment degeneration. Currently, there is information that they are able to relieve blindness. But studies have been conducted so far only on mice.
Forecast
The outcome of the disease directly depends on the timeliness of going to the doctor. Against the background of competent treatment of retinal pigment degeneration at an early stage of its development, the pathological process can be slowed down, sometimes even stopped.
In severe cases, the prognosis is poor. At present, there is no such treatment method that would permanently eliminate pathology. With an untimely visit to a doctor, cataracts and glaucoma develop. First, the field of view narrows, then it disappears completely.
Doctors Recommendations
Persons with a pathology identified need to make adjustments to their lifestyle. This not only increases the effectiveness of treatment of retinal pigment degeneration, but also serves as a preventive measure for the development of other diseases of an ophthalmic nature.
Doctor's recommendations:
- It is important to monitor the degree of illumination of the workplace. The light should be bright enough, but not sharp. Doctors recommend placing a table lamp at a distance of 50 cm from the head.
- It is desirable to place the computer monitor at arm's length. If it is closer, the eyes will undergo increased stress.
- If daily activities are connected with working at a computer, a five-minute break must be arranged every hour. At this time, it is recommended to do at least the simplest exercises, for example, to look from a distant object to a near one.
- Do not read in moving vehicles.
- It is necessary to make adjustments to the diet. The menu must necessarily contain foods rich in vitamins A and D.
- Cleanse your skin regularly. Ignoring the rules of hygiene can lead to the development of infectious diseases, which will significantly worsen the course of the disease. It is important to know that with retinal pigment degeneration, the bath and sauna are prohibited.
Following these recommendations in a shorter time helps to stop the progression of the pathology.
Finally
Retinal pigment degeneration is a disease characterized by a gradual narrowing of the visual fields. The danger of the disease lies in the fact that at an early stage of development it is asymptomatic. Most patients turn to an ophthalmologist even when various complications arose. The ICD code for retinal pigment degeneration is H35.5.