Differential diagnosis
Based on the above mentioned history, symptoms, visual function and what is seen on the examination of the examiner, the diagnosis is not too difficult. However, when differentiated from some secondary retinitis pigmentosa following congenital or acquired chorioretinal inflammation, care should be taken.
In congenital syphilis and fetal fundus lesions caused by a pregnant woman with a wind diagnosis in the third trimester, the fundus findings after birth are almost identical to this disease, and the findings of ERG, visual field and other visual function tests are indistinguishable. The diagnosis of primary pigmentary degeneration can only be made when it is established that the child’s parents are seronegative for syphilis and the mother has no history of rubella in early pregnancy. If necessary, a longer follow-up is required. Congenital secondary pigmentary degeneration is present at birth and is quiescent.
Acquired syphilis and certain acute infectious diseases (such as smallpox, measles, scarlet fever, mumps, etc.) can occur with chorioretinitis, and the fundus changes after the inflammation subsides are sometimes similar to primary pigmentary degeneration. When differentiated by medical history, serologic examination, and fundus pigment spots that are large and deeply located, irregularly formed (non-osteoblast-like), with choroidal retinal atrophy spots, grayish (not waxy yellow) optic disc atrophy, and less severe night blindness.
Complications
Posterior polar cataract is a common complication of this disease. It usually occurs in the late stage, with star-shaped clouding in the posterior subcapsular cortex, and progresses slowly, eventually leading to clouding of the entire lens. About 1% to 3% of cases are complicated by glaucoma, mostly wide angle, and closed angle is rare. It has been statistically studied that glaucoma is a concomitant rather than a complication of the disease. Approximately 50% of cases are associated with myopia. Myopia is most often seen in patients with autosomal recessive and sex-linked recessive inheritance. It can also be seen in other members of the family. Deafness is also seen in up to 19.4% of cases with this disease. The progressive degeneration of both the retina and the inner ear organ of Corti originates from the neuroepithelium, so both may derive from the same gene.
Pigment degeneration and deafness can occur not only in the same patient but also in different members of the same family, but they do not appear to be genetically distinct and may be due to pleiotropy of the same gene. The disease can be associated with other genetic disorders, the most common being Laurence-Moon-Bardt-Biedl syndrome in which both the pituitary region of the mesencephalon and the retina are affected. Typically, the syndrome has five components: retinitis pigmentosa, genital hypoplasia, obesity, polydactyly, and mental retardation. The syndrome appears early in development, with significant clinical manifestations around 10 years of age (or earlier), and those who do not have all five components are called incomplete. In addition, it is rare for the syndrome to be associated with complications or concomitant diseases of the eye or other organs.
Dangers
Retinitis pigmentosa is a hereditary progressive chronic disease that affects both eyes and is caused by degeneration and atrophy of the optic nerve and retina. Its main clinical manifestations are night blindness, progressive visual field reduction and pigmentation in the shape of bone cells in the retina. It is more common in men than in women. It is common for several members of a family to suffer from this disease, and it is particularly common in children of consanguineous marriages. New Vision Eye Hospital says that patients with this disease and their families may also have symptoms such as mental disorders, epilepsy or mental retardation, or sometimes deafness or congenital malformations. In a few cases, there is no family history of the disease.
Prevention
Patients with recessive inheritance of this disease have early onset, severe disease, rapid development, and an extremely poor prognosis. The prognosis is extremely poor, with a high degree of poor visual function by the age of 30 and near total blindness by the age of 50. The prognosis is relatively better than that of the recessive type. Therefore, the prognosis is relatively better than that of the recessive type. Therefore, it is possible to wait until there is a chance of barely normal schooling and employment. In recessive cases, the ancestors have a history of consanguineous smoking, and prohibiting consanguineous smoking can reduce the incidence of the disease by about 22%. In addition, recessive patients should try to avoid marrying people with a family history of the disease, and should not marry people who also have the disease. Patients with dominant inheritance have a 50% risk of developing the disease in their children.
Treatment
Stem cell therapy for retinitis pigmentosa mainly involves stimulation of the optic nerve with a weak electric current, which activates the optic nerve cells and enhances the bioelectrical excitability of the optic nerve; it also strongly stimulates the intraocular peripheral vascular bundles, which greatly improves the blood circulation and oxygen supply to the fundus tissues, thus restoring some of the functions of the optic nerve fibers by providing them with adequate blood and oxygen supply. This process of using stem cells to treat retinitis pigmentosa can improve vision and consolidate it by injecting stem cells into the eye to repair damaged optic nerve and retinal cells.
Food therapy recipes
There are many folk remedies for retinitis pigmentosa, and some of the commonly used dietary remedies are
(1) 90 grams of sheep liver and 100 grams of fresh sweet potato leaves. Boiled and eat liver and drink soup.
(2) 100 grams of pig liver, 15 grams of nightshade. Decoct soup with nightshade, remove the dregs and then boil the liver, drink the soup and eat the liver.
(3) Carrot, sliced oil fried, no salt, vinegar, eat more times.
(4) pig liver boiled leek: boil pig liver and leek each in appropriate amounts without adding salt, eat liver and drink soup, it is appropriate to take for a long time, can nourish the liver and blood and brighten the eyes. It can treat retinal pigment degeneration, which is manifested by the inability to see things at night, or treat blurred vision in children.
(5) Chinese wolfberry porridge: 30 grams of Chinese wolfberry, 60 grams of round-grained rice, add the right amount of water, the usual method of cooking porridge for breakfast or dinner. Can nourish the kidney and liver, benefit the essence of the eyes. Used for retinal pigment degeneration due to liver and kidney deficiency.
(6) Sauce and vinegar sheep liver: 500 grams of sheep liver, wash and slice, mix with wet starch, fry in a hot frying pan, add a little ginger, onion, cook with yellow wine, soy sauce, vinegar, sugar and other seasonings, tender cooked. Eat with meals, often taken, can nourish the liver, blood and eyes. Cure night blindness and diminished vision.
(7) shouwu pig liver: with shouwu 15 grams, 400 grams of fresh pig liver, first shouwu washed with water into a large bowl, yellow wine steam for about 1 hour, take out with Chinese medicine, pepper, pepper together into a gauze bag, tighten the bag, and then the thick part of the pig liver cut with a knife into a knife, rinse with water, set in a pot, add the bag, onion, ginger, garlic, salt and other seasonings, add the right amount of water, boil over high heat, switch to simmering, cooked and cut open, dipped in sesame oil, garlic paste, and eaten with meals. It has the effect of nourishing the liver and kidney and benefiting the essence and blood. Can complement the treatment of liver and kidney deficiency of night blindness, dimming vision, premature graying of the hair, blood deficiency dizziness, lumbar and leg weakness and other diseases.
(8) sweet potato porridge: 250 grams of fresh sweet potato, 100 to 150 grams of round-grained rice, sugar. Wash the sweet potatoes, cut into small pieces with skin, add water and japonica rice with the thin porridge, when the porridge is almost ready, add the right amount of sugar, and then boil two or three. Take 2 times a day, eat while hot, has the effect of strengthening the spleen and nourishing the stomach, benefitting the qi and replenishing the deficiency. Can cure night blindness and constipation, etc.
(9) Animal liver porridge: 100~150 grams of animal liver (pig liver, sheep liver, cow liver, chicken liver are available) and 100 grams of round-grained rice. Wash and cut animal liver into small pieces, add about 700 ml of water with japonica rice, then add onion, ginger, oil and salt to make a thin porridge, and when the liver is cooked and the porridge is thick, it can be eaten. Eat it every morning on an empty stomach while it is still hot, it can nourish the liver, nourish the blood and brighten the eyes. It can treat night blindness, dizziness, noma, anemia, etc. caused by weakness of qi and blood.
(10) pig liver wolfberry leaf soup: 200 grams of pig liver, 150 grams of fresh wolfberry leaf, the first pig liver washed and cut strips, cooked with wolfberry leaf, drink soup and eat liver, 2 times a day. It can benefit the essence and nourish the liver. It is used to treat night blindness and diminished vision, and has the effect of improving vision.
(11) stewed carp soup: fresh carp washed, stewed into soup, eat fish and drink soup. It is suitable for night blindness, dry eye disease, etc.
(12) 2 pairs of chicken livers, 15 grams of cereal grass and 10 grams of nightshade. Wash the chicken liver, put it into a basin with Gou Jing Cao and Nightshade Sand, add a little water, steam it over water, eat the liver and drink the juice. It can clear heat and brighten eyes, nourish blood and moisten dryness, cure night blindness, dry eyes, children’s noma eyes, etc. Eat more effective.
(13) 50 grams of pine needles (leaves), 50 grams of pig liver or chicken liver, cooked together, remove the residue, eat the liver and drink the soup. It can nourish the liver and brighten the eyes. Used to treat night blindness and blurred vision, etc.
(14) Cuscuta congee: 30~60g of cuscuta (60~100g for fresh), wash and pound, decoct the juice, add 100g of hard rice to cook the congee, add sugar when the congee is ready, boil and mix slightly, and consume in 2 times. It can nourish the kidneys and benefit the essence, nourish the liver and brighten the eyes.
(15) Longan mulberry paste: 1000 grams of mulberry, 500 grams of longan meat, add water, simmering paste, 10 grams per serving, 2 times a day. Nourishing the liver and kidney, nourishing blood and brightening eyes, can be used for retinal pigment degeneration due to liver and kidney yin deficiency and deficiency of qi and blood.
Preventive and therapeutic recipes
Recipe 1 Drunken shrimp
Ingredients: shrimp 1XL shochu appropriate amount.
How to use: take live shrimp 1 pair (or fresh), rinse with water, put it in the wine and fish it out after intoxication, add seasonings can be, eaten with meals.
Efficacy: warming the kidney and Yang.
Retinitis pigmentosa, a type of deficiency of kidney yang, initially at dusk or in the dark, difficulty in movement, until dawn or light vision is normal again, and over time the disease is serious, or even blindness, cold limbs, lumbar and knee weakness.
Source: Shen Qingfa. Chinese Medicine Dietetics. Shanghai: Shanghai Science and Technology Literature Press, 2000, 313
Formula 2 Rabbit Liver Congee
Ingredients: 1 fresh rabbit liver, 100 g of round-grained rice.
How to use: Wash the rabbit’s liver, chop it, and cook the porridge with round-grained rice, adding salt and grated ginger.
Effects: Nourishing liver and kidney.
Retinitis pigmentosa, a type of Yin deficiency of the liver and kidney, with unclear vision at dusk or in the dark, narrowing of the visual field, or even narrowing like a tube, and eventually blindness, dryness and discomfort in the eyes, dizziness and tinnitus, insomnia and dreaminess.
Source: Xia Xiang, et al. The Complete Book of Family Food Nourishment and Food Therapy. Shenyang: Liaoning Science and Technology Press, 1999, 748
Formula 3 Steamed river eel
Ingredients: fresh river eel (about 250 g), 10 water chestnuts.
How to use: Slaughter and wash the river eel, peel the water chestnuts, add ginger, onion, salt and monosodium glutamate, steam them in water and eat them with meals.
Effects: Nourishing the liver and kidney.
Indications: Retinitis pigmentosa, a type of liver and kidney yin deficiency, blurred vision in the twilight or dark places, dryness and discomfort in the eyes, dizziness and tinnitus, insomnia and dreaminess.
Source: Xia Xiang, et al. The Complete Book of Family Food Nourishment and Food Therapy. Shenyang: Liaoning Science and Technology Press, 1999, 748
Formula 4 Coix Seeds and Pork Belly Congee
Ingredients: 1 set of pork belly, 100 grams of coix seeds, 150 grams of round-grained rice.
How to use: Wash the pork belly, put in coix seeds, japonica rice and salt, tie both ends of the pork belly with thread, take out and cut the pieces after stewing, and consume in portions.
Effects: Tonifies the liver and benefits the qi.
Retinitis pigmentosa, weakness of spleen qi, unclear vision at dusk or in the dark, white face, fatigue, low food intake.