Retinosis pigmentaria

色素性视网膜变性
  • 文章类型: Journal Article
    遗传性视网膜营养不良(IRD)是劳动人口中合法失明的主要原因。囊性黄斑水肿(CME)是视力丧失的可治疗原因之一,影响高达50%的患者。结合“遗传性视网膜营养不良”进行了书目审查,“色素性视网膜炎”,“黄斑水肿”和根据“美国医疗保健研究和质量机构”的证据和建议水平的诊断治疗方案。该协议已在XAREADHR小组的每月会议上进行了讨论,超过25位眼科医生参加了会议,达成共识文件。CME的病因是多因素的:血-视网膜屏障的功能障碍,视网膜色素上皮,还有穆勒细胞,炎症,和玻璃体牵引.OCT是与IRD相关的CME的诊断和随访的首选测试。具有最高科学证据的药物是碳酸酐酶抑制剂(IAC)。玻璃体内皮质类固醇,抗VEGF,和玻璃体切割剥离内界膜没有足够的证据。针对成人IRD中的CME提出了一种治疗方案,另一个用于儿科患者,另一个用于IRD和白内障手术。口服和局部IAC可有效治疗IRD继发的CME。用皮质类固醇治疗,抗VEGF,玻璃体切除术是二线选择。需要进行随机临床试验以建立这些患者的治疗量表。
    Inherited retinal dystrophies (IRD) are the leading cause of legal blindness in the working population. Cystic macular edema (CME) is one of the treatable causes of visual loss, affecting up to 50% of the patients. A bibliographic review has been carried out combining \"inherited retinal dystrophy\", \"retinitis pigmentosa\", \"macular oedema\" and a diagnostic-therapeutic protocol according to the levels of evidence and recommendations of the \"US Agency for Healthcare Research and Quality\". This protocol has been discussed in the monthly meetings of the XAREA DHR group with the participation of more than 25 ophthalmologists, creating a consensus document. The etiology of CME is multifactorial: dysfunction of the blood-retinal barrier, retinal pigment epithelium, and Müller cells, inflammation, and vitreous traction. OCT is the test of choice for the diagnosis and follow-up of CME associated with IRD. The drugs with the highest degree of scientific evidence are carbonic anhydrase inhibitors (IAC). Intravitreal corticosteroids, anti-VEGF, and vitrectomy with peeling of the internal limiting membrane do not have sufficient evidence. A treatment scheme is proposed for the CME in IRD in adults, another for pediatric patients and another for IRD and cataract surgery. Oral and topical IACs are effective in the treatment of CME secondary to IRD. Treatment with corticosteroids, anti-VEGF, and vitrectomy are second-line options. Randomized clinical trials are required to establish the therapeutic scale in these patients.
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  • 文章类型: Case Reports
    60岁的女性提到视力残疾。她在所有周边视网膜出现骨针色素沉着和视网膜萎缩,以及黄斑视网膜斑点。多模式成像显示了两种遗传性视网膜营养不良(IRD)的典型发现。视网膜电图证实棒功能障碍。在ABCA4和CNGA1基因中发现双等位基因突变。虽然不常见,不同的IRD可以同时存在于同一患者中。这是首例RP与迟发性Stargardt病合并的病例。我们建议将这种新型临床实体命名为“Stargardt的色素变性”。
    60-year-old woman referring visual disability. She presented bone spicule pigmentation and retinal atrophy in all peripheral retina, as well as macular retinal flecks. Multimodal imaging showed typical findings of both inherited retinal dystrophies (IRD). Electroretinogram confirmed rod dysfunction. Biallelic mutations were found in ABCA4 and CNGA1 genes. Although not common, different IRDs may be present in a same patient at the same time. This is the first reported case of the combination of RP with late-onset Stargardt\'s disease. We propose the name \'Stargardt\'s pigmentosa\' for this novel clinical entity.
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  • 文章类型: Journal Article
    视网膜色素变性(RP)是一组遗传性疾病,导致视网膜退化和视力下降。世界卫生组织报告说,全球约有13亿人受到某种类型的视力障碍的影响。患病率为每4000名居民中的1名,它是遗传起源失明的第一个原因,男性占60%,女性占40%。世界上缺乏这种病理学的信息,主要是关于这种疾病的现有治疗方法,因此,本文献综述旨在更新现有或研究中的治疗方法,并告知每种治疗方法的局限性。对科学文献的审查是通过咨询PubMed和WebofScience等数据库进行的,搜索将仅限于2018-2022年的文章。研究中有几种类型的治疗方法:基因治疗,经角膜电刺激,使用神经保护剂,视源治疗,干细胞移植和寡核苷酸治疗,这将在本文中讨论,他们的好处和现有的障碍在每个治疗实验。总之,这些疗法中的每一种都有望在未来为色素性视网膜炎的选择性人群提供可行的治疗方法,然而,一些疗法在疾病开始时显示出益处,从长远来看,它们会失去效力。
    Retinitis pigmentosa (RP) is a group of inherited diseases that lead to degeneration of the retina and decreased vision. The World Health Organization reports around 1,300 million people affected by some type of visual impairment worldwide. The prevalence is 1 in every 4000 inhabitants and it is the first cause of blindness of genetic origin, frequent in men with a percentage of 60% and 40% in women. There is a lack of information on this pathology in the world, mainly on the existing treatments for this disease, so this bibliographic review aims to update the existing or under-study treatments and inform the limitations of each of these therapies. This review of scientific literature was carried out by consulting databases such as PubMed and Web of science, the search will be limited to articles from the years 2018-2022. There are several types of therapy in studies: gene therapy, transcorneal electrical stimulation, use of neuroprotectors, optogenic therapy, stem cell transplants and oligonucleotide therapy, which will be discussed in this article, both their benefits and the existing barriers in each treatment experimental. In conclusion, each of these therapies promises a viable treatment in the future for selective groups of people with retinitis pigmentosa, however, some therapies have shown benefit at the beginning of the disease, losing their efficacy in the long term.
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  • 文章类型: Case Reports
    Long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency is a rare metabolic disease caused by a specific mutation in the HADHA gene, which leads to an alteration in the metabolic pathway of fatty acids. Its most frequent form of presentation at the ophthalmological level is retinitis pigmentosa, and in some cases the ophthalmologist could be the first one to alert the other paediatric specialties to carry out a multidisciplinary approach to the case. The case is presented of a patient with long-chain 3-hydroxyacyl-CoA dehydrogenase deficit detected in neonatal screening, and which clinically debuted as pigmentary retinosis with no alteration in visual acuity as observed in the fundus images and optical coherence tomography of the retina provided. Finally, a review of the literature of this potentially lethal pathology is presented, and the main pathological and clinical features are highlighted.
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  • 文章类型: English Abstract
    BACKGROUND: Retinitis pigmentosa is the most common chronic and inherited condition of retinal dystrophy. The progressive involvement of retinal photoreceptors and other layers characterize this condition. This situation results in optic disc pallor and retinal pigment deposition vascular attenuation.
    METHODS: We present the case of a 15-year-old male with a history of 6 months evolution characterized by night blindness and bilateral impairment of superior temporal vision.
    CONCLUSIONS: This type of dystrophy is a genetic and progressive eye condition that begins during adolescence and produces visual impairment.
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