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Information on Retinitis Pigmentosa


Description

Retinitis pigmentosa causes the degeneration of photoreceptor cells in the retina. As these cells degenerate and die, patients experience progressive vision loss.

Photoreceptor cells capture and process light helping us to see. There are types of photoreceptor cells: rod cells and cone cells. Rod cells are concentrated along the outer perimeter of the retina. Rod cells help us to see images that come into our peripheral or side vision. They also help us to see in dark and dimly lit environments. Cone cells are concentrated in the macula, the center of the retina, and allow us to see fine visual detail in the center of our vision. Cone cells also allow us to perceive color.

Most forms of RP begin with the degeneration of rod cells, which causes night blindness. Patients with Retinitis pigmentosa cannot adjust well to dark and dimly lit environments. As the disease progresses and more rod cells degenerate, patients lose their peripheral vision. Patients with Retinitis Pigmentosa often experience a ring of vision loss in their mid-periphery with small islands of vision in their very far periphery. Others report the sensation of tunnel vision, as though they see the world through a straw. Many patients with Retinitis Pigmentosa retain a small degree of central vision throughout their life.

Other forms of Retinitis Pigmentosa, sometimes called cone-rod dystrophy, first affect central vision. Patients first experience a loss of central vision that cannot be corrected with glasses or contact lenses. With the loss of cone cells also comes disturbances in color perception. As the disease progresses, rod cells degenerate causing night blindness and peripheral vision.

Nyctalopia (night blindness) is a decreased ability to see in reduced illumination that is seen in patients with impaired rod function; often associated with a deficiency of vitamin A. Patients may report difficulty driving in low light, at dusk, or in fog. Dark stairwells, movie theaters, and restaurants are situations where the transition between bright illumination and semidarkness may also present difficulties to some patients.

Ring scotoma or loss of peripheral vision may be profound before the patient explicitly recognizes it. Symptoms may include bumping into furniture or door-frames or difficulty in playing games (eg, tennis, basketball, baseball).

Causes

Retinal cells are among the most specialized cells in the human body and depend on a number of unique genes to create vision. A disease-causing mutation in any one of these genes can lead to vision loss. To date, Foundation researchers have discovered over 100 genes that can contain mutations leading to Retinitis Pigmentosa.

Other inherited diseases share some of the clinical symptoms of RP, including: Usher syndrome, which causes both hearing and vision loss, Bardet-Biedl (Laurence-Moon) syndrome, Best disease, choroideremia, gyrate-atrophy, Leber congenital amaurosis, and Stargardt disease.

Mucopolysaccharide disorders may be associated with RP. These include: Hurler syndrome, Scheie syndrome, Sanfilippo syndrome.

Mitochondrial disorders may also be associated. Kearns-Sayre syndrome manifests as ptosis, external ophthalmoplegia, and heart block.

Abetalipoproteinemia is an autosomal recessive disorder in which apolipoprotein B is not synthesized, leading to fat malabsorption, fat-soluble vitamin deficiencies, spinocerebellar degeneration, and retinal degeneration. The red blood cells show acanthocytosis.

Conventional Labs

The Electroretinogram (ERG) is the most critical diagnostic test for RP because it provides an objective measure of rod and cone function across the retina.

Formal visual field measurements are useful for ongoing follow-up care of patients with RP because a progressive loss of side vision is often the major symptom along with visual acuity changes.

The following tests are useful in excluding masquerading diseases or detecting conditions that are associated with RP:

VDRL and FTA-ABS tests

Serum phytanic acid when other neurologic abnormalities are present

Ornithine levels in patients where a diagnosis of gyrate atrophy may be confused with RP

ECG to rule out heart block in patients with suspected Kearns-Sayre syndrome

Lipid profile with possible protein electrophoresis in patients with suspected abetalipoproteinemia

Antiretinal antibodies, particularly antirecoverin antibodies may be present

Specialty Lab Tests



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What's your next step?

The next step, after you have been diagnosed with a disease, is to find out what is the specific cause, and then choose supplements that address it. Phone consults are my specialty. Please call my at (239) 659-2684 to schedule a consultation.

The choice is yours

I recommend that you make an informed choice, and the goal of this web site is to provide you with the information to make a wise choice when it comes to your health and wellness.

As you can see, I don't sell any vitamins on this web site. There are thousands of vitamin stores that will sell you whatever vitamin you want, and many of them offer discounts.

If you are interested in some high-quality basic nutritional supplements, I recommend visiting the Store You will find my recommendations for a multiple, tasty chewable fiber wafers, high-potency probiotics, and fish oils.

Good luck in your journey towards health and wellness!!

Why don't you tell me what vitamins to take for this disease?

Unfortunately, that would be a clear violation of FDA regulations. Also, one of the most important aspect of naturopathy is: "Treat the person, not the disease". This is a profound statement, and many people have spent thousands of dollars on vitamins listed in books or web sites for a specific disease. This is what I call "vending machine medicine". It rarely works! The solution is to find a naturopathic physician, such as myself, to assist you.


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Ronald Steriti, ND, PhD
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Information on this site is provided for informational purposes only and is not meant to substitute for the advice provided by your own physician or other medical professional. You should not use the information contained herein for diagnosing or treating a health problem or disease, or prescribing any medication. If you have or suspect that you have a medical problem, promptly contact your health care provider. Information and statements on this site have not been evaluated by the Food and Drug Administration.

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