What Is Retinitis?

Retinitis

Retinitis

Retinitis leads to retinal tissue edema, exudation, and bleeding, which cause varying degrees of vision loss; usually secondary to choroiditis, leading to choroidal retinal inflammation. The causes are exogenous and endogenous. Eye symptoms are not obvious, mainly manifested as vision loss and even blindness.

Causes of retinitis

Retinitis

Exogenous: Bacteria, viruses, chemical toxins and other foreign substances enter the eye, or irritation of parasites in the eye, causing choroiditis, choroidal retinal inflammation, exudative retinitis, etc .; endogenous: secondary to some Infectious diseases, such as canine distemper, canine infectious hepatitis, leptospirosis, etc., bacteremia or sepsis occur, pathogenic microorganisms transfer to the retinal blood vessels through the blood, and sepsis appears in the eye tissue, causing retinitis; this disease It may also be caused by an allergic reaction to a local lesion.

Director of the Department of Ophthalmology, Director of the Beijing Armed Police Second Hospital, Director of the Department of Ophthalmology Yang Chunhua, and Director of Director Zhang Zhenyi, after repeated clinical practice for nearly thirty years, adopted "Heller's artery ring and vortex vein collateral circulation to establish retinal pigment degeneration with an effective rate of 95.6%. Prof. Cai Haoran, a doctoral supervisor of Peking University's visual research center, confirmed that the electro-physiological contrast test before and after surgery confirmed that the curative effect is significant. The establishment of Heller's arterial annular vortex vein collateral circulation is based on the pathological changes of retinal pigment degeneration, and the outer choroid layer The circulation metabolism of the large blood vessels, the optic nerve meningeal vascular network, the anterior and ethmoidal regions of the optic papillae, and the retinal sector have been significantly improved and the visual function has been reversed. Early (electroretinal unextinguished) vision can be greatly improved after surgery, Widen the field of vision, and the electrogram of the visual network gradually returned to normal. In the middle and advanced patients (the retinal diagram was extinguished, the computer vision remained above 10 degrees, and the central vision was above 0.1), the vision improved slightly after surgery, and the visual field improved. Changes, a follow-up visit one year after surgery, the electroencephalogram light peak dark valley Adenby improved.

After 27 years of intensive research and unremitting exploration, a special research group led by Director Yang Chunhua and Director Zhang Zhenyi has carried out surgical intervention for the important intermediate link of retinal pigment degeneration and choroidal microcirculation abnormality. Improved the academic argument of "establishment of collateral circulation from autologous blood vessels" in the treatment of retinal pigment degeneration. The surgical design does not damage the original vision and field of vision, and is a safe and effective surgical treatment option at this stage. In the course of basic theoretical research and clinical practice, he was supported by Professor Cai Haoran, a doctoral tutor of the Peking University School of Medicine and an expert in bioelectricity. Through strict visual physiology before and after surgery: electroretinogram (F-ERG), electrooculogram ( The comparison of the parameters of EOG and visual evoked potential (P-VEP) fully demonstrates the effectiveness of this surgery in the clinical treatment of patients with retinal pigment degeneration. According to the medical health information of the Ministry of Health, it is concluded that the treatment methods that can cause visual electrophysiological improvement in patients with retinal pigment degeneration have not been reported in the same literature at home and abroad. It is confirmed that this special medical service project is at the leading level in the field of ophthalmology at home and abroad.

Retinitis pigmentosa is a difficult disease in ophthalmology, known as incurable disease. It is a hereditary chronic eye disease that originates from retinal dystrophy. It affects both eyes. There are about 300,000 domestic patients and about 3 million worldwide. Its clinical features are early night blindness, concentric constriction of the visual field, and finally a tubular visual field. Binocular blindness or frequent blindness occupies a considerable proportion of blindness. Retinitis pigmentosa (RP) is a hereditary rod and cone dystrophy disease. It is characterized by night blindness, reduced visual field, and fundus bone cell-like pigmentation. For decades, many basic studies in the ophthalmology field at home and abroad have confirmed that "retinitis pigmentosa is associated with reduced choroidal blood flow." The formation of night blindness and tubular visual field indicates that choroidal blood flow can no longer meet the metabolic needs of rod cells, and the area of choroidal capillaries. Corresponding decline in blood circulation function. After performing "autologous blood vessel collateral circulation establishment surgery" on more than 3,000 patients in China, Japan, the United States, Germany, Kazakhstan, Myanmar, Mongolia, the Philippines, Canada and other countries, our center confirmed that early and middle-term patients can be treated with surgery. Improve vision and widen the field of vision to varying degrees, and the total effective rate of improvement of the fundus reaches 96%; advanced patients can effectively prevent the progress of the disease and delay blindness. Basic medicine promotes the advancement of clinical medicine. The clinical practice of surgery has verified that this surgical design is consistent with the research results of ocular microcirculation theory at home and abroad. Retinal pigment degeneration is a congenital hereditary blindness disease that is primarily caused by omental choroidal dystrophy, with retinal pigment epithelium and retinal dysfunction as the main clinical manifestations. The population incidence in China is about 1/4000, with more than 300,000, and more than 3 million patients worldwide. The clinical manifestations are early night blindness, progressive narrowing of the visual field, and severe cases are tubular. Eventually, central vision declines and gradually blindness or frequent blindness occurs.

Once the patient's conclusion of the disease (incurable disease) has caused great psychological damage to the patient, it also casts a shadow on the happy family and heals the treatment. The long medical career is exhausting, but eventually he cannot get rid of blindness. Doom. This project has achieved remarkable results through repeated clinical practice for up to 18 years, which is confirmed by contrast electrophysiological tests before and after surgery. Searched by the Institute of Medical Information of the Chinese Academy of Medical Sciences, it is concluded that the same domestic and foreign literatures have not been reported for the treatment methods that can cause ophthalmic electrophysiological improvement. Although retinal pigment degeneration is a hereditary disease, microcirculation disorders of the retina and choroid have played a vital role in the occurrence and development of the disease. The medicine of the motherland calls this disease "high wind cataract" and "high wind sparrow", which is due to lack of congenital endowment. In the 1970s, Soviet ophthalmologists proposed to improve choroidal microcirculation to treat this disease. In 1990, British ophthalmologists confirmed that retinal pigment degeneration is associated with decreased choroidal blood flow. This theory was confirmed again by Doppler tests with Yang Wenli and others at Beijing Tongren Hospital in 1999. . According to the pathological changes of retinal pigment degeneration, the center adopts the establishment of collateral circulation surgery, which significantly improves the circulation metabolism of the outer choroidal large blood vessels and the retinal fan zone, and the visual function is reversed. Breaking new ground for treating patients with retinal pigment degeneration.

Due to the continuous improvement of surgical methods and the gradual improvement of adjuvant treatment, early patients can improve their vision after surgery, widen their field of vision, and the electroretinogram can gradually return to normal or receive normal; in the middle period, patients can improve their vision, and the visual field and electroretinogram cannot be changed. However, the light peak, dark valley, and Arden ratios of the electroencephalogram in 60% of the patients after one year improved or are close to normal; advanced patients can effectively prevent the disease from developing after surgery. The experts of the center advised that patients with retinal pigment degeneration should pay close attention to the changes of electroretinogram and computer visual field graphics once the diagnosis is made. Do not delay the treatment and cause irreversible visual function damage. So far, 550 patients have been successfully treated and all have received good results. Among them, 26 patients were observed for 5-15 years. The long-term effect was significantly better than the short-term effect. No complications were found. Once patients with retinal pigment degeneration are diagnosed, they should pay close attention to the changes in electroretinogram, computer vision, and fundus, and perform surgery in the early and middle stages to avoid delaying the treatment and causing irreversible visual function damage, so as to strive for better efficacy. All medical staff in our center will make unremitting efforts to provide the best possible medical services for patients with retinal pigment degeneration.

RP is the abbreviation of Retinitis Pigmentosa, which is the abbreviation of Retinitis Pigmentosa. Retinitis Pigmentosa is a chronic, progressive, hereditary, dystrophic retinal degeneration. Because the prognosis of this disease is not good, the Hong Kong Oriental Daily s headline of "horrible retinal pigment lesions" and its cause are unknown, cannot be treated, and should not be detected. The subtitles of genetic offspring remind people to pay attention to the severity of retinal pigment degeneration. The Hong Kong Wen Wei Po under the headline "Retinal Eye Diseases Do Not Make Night Blindness" and experts warned that under the heading of retinal pigment degeneration will unknowingly take away vision, people are warned to recognize the dangers of retinal pigment degeneration to patients' eyes.

Retinitis pigmentosa is one of the serious eye diseases that cause blindness today. Statistics from the American ophthalmology community show that in the 20--40 age group, retinal pigmentosis is the main blinding eye disease. According to rough statistics, there are about 1.5 million patients with retinal pigment degeneration around the world. This amazing number does not decrease year by year, but increases day by day. Isn't this enough to attract the attention of the world! In the early stages of retinal pigment degeneration, there are only symptoms of night blindness, which does not affect work, study and normal life at all, and the disease is unknown Impaired vision without realizing it. Especially for children in early childhood, it is more difficult to detect early. The retinal structure is precise and the function is complicated. It is the intraocular tissue of the posterior segment of the eyeball that cannot be seen with the naked eye. In 1851, Helmhotz invented the ophthalmoscope, and the fundus changes of retinal pigment degeneration were revealed. Despite this, treatment is still empty talk. Only in the 1970s did retinal pigment degeneration attract the attention of western developed countries. This disease was found in China in the early Qing Dynasty, and was called "sparrow cataract" at that time. As the name suggests, it is just right. The name of the disease is good, and the basis of dialectical treatment is also given. For example, it is mainly based on strengthening the spleen and replenishing qi, adding spleen and promoting blood circulation prescriptions, and cooperating with acupuncture, massage, qigong and nourishing drugs. currently using.

Medical genetics is the main component of human genetics. It is a marginal science combining genetics and medicine. It explores the relationship between the occurrence and development of human diseases and genetic factors to provide the scientific basis for diagnosis, treatment, and prevention of genetic diseases. So as to contribute to improving the quality of hot mouth. With the continuous development of medicine, people's living standards continue to improve, most infectious diseases have been controlled, and some have disappeared. Some chronic non-infectious diseases have gradually increased and become a prominent problem in modern medicine. So far, people have realized that hereditary diseases have exceeded With 5,000 species, it poses a great threat to human life and health. However, with the rapid development of modern high technology, the research of basic medicine, especially immunology and molecular biology and genetics, has also advanced in depth and breadth. Cytogenetics and molecular genetics, which are studied from the cellular level and the molecular level The development is more rapid, making genetic diagnosis and gene therapy of some hereditary diseases more likely. For example: after taking out cells from a patient, genetically modifying them, and then reinjecting them into the body, the abnormal genes are artificially changed to achieve the purpose of preventing and treating genetic diseases; a research institution at Boston University in the United States injected a gene that controls the secretion of vascular endothelial growth factor This gene can instruct the human body to grow new blood vessels. Achievements in molecular genetics research and gains in manipulating human genetic combinations have made it possible to apply recombinant DNA technology to treat diseases. Although this genetic engineering is currently in the exploratory and experimental stage, it is expected that humans will be The sequence of 100,000 genes on the chromosome was figured out, and a complete human genome map was drawn-"The Blueprint of Life." I believe this is a directional and essential measure. With the advancement of immunogenetics and surgery, the prospects for some difficult-to-treat genetic diseases, such as the treatment of retinal pigment degeneration, are encouraging. The French poet Goethe said, "All I have to do is to reach out and harvest the crops that others have planted for me." What I do is to sort out the "fruits" that others have harvested and dedicate them to the reader. . Due to our limited level, less experience, and lack of information on hand, there will be many mistakes. I would like to thank your fellow eye doctors and readers for corrections. We are grateful for this. The purpose of our establishment of this scientific research website is to call on all sectors of the society to pay attention to the genetic disease of retinal pigment degeneration, to provide as much support and assistance to patients as possible, and to awaken people's understanding of retinal pigment degeneration. At the same time, I call for fellow ophthalmologists to carry out scientific research collaborations and website exchanges so that more RP patients can be effectively controlled and satisfied with their treatment. If the patients with retinal pigment degeneration can get some inspiration from our website, summon the courage of life, and realize that the colorful world will not leave you, then we will be very pleased. There are methods in the literature to try vasodilators, vitamins A and B1, tissue therapy, various hormones, Chinese herbs, acupuncture and other methods, or to avoid rapid deterioration of visual function.

Clinical manifestations of retinitis

Retinitis

1. Symptoms: central vision loss and deformed vision.

2. Fundus changes: The localized gray-white or gray-yellow exudation of the macula is round or oval, the border is unclear, slightly bulging, the size is about 1/4 to 1 nipple diameter, and there is an arc or Circular bleeding and hard lipid exudation, with superficial retinal detachment. Late lesions are absorbed and scar tissue is formed.

3, the visual field inspection has a central dark spot.

4. Fluorescence angiography: New blood vessels originating from the choroidal pigment subepithelium or neuroepithelial can be seen. Peripheral bleeding forms a fluorescent shield.

The main clinical manifestations of this disease are central vision loss, central dark spots, and deformed vision. There were no inflammatory changes in the anterior segment and vitreous. The fundus has yellowish-gray exudative lesions and hemorrhage in the macula, round or oval, with unclear borders, and slight bulges, about 1/4 to 3/2 optic disc diameter (PD). Below 1PD is more common.

Curved or ring-shaped bleeding at the edge of the lesion, and occasional radial bleeding. There is a pigmented disorder around the lesion. In many cases, the discoid retinal detachment is superficial, and in some cases there is hard lipid exudation. Most of the lesions are centered in the fovea, with a radius of 1 PD. At the end of the course, yellow-white scars formed in the macula. Fluorescent fundus angiography examination, in the early or arterial phase of the artery, is equivalent to a variety of new blood vessel networks such as granules and lace at the exudation. The bleeding area shields the fluorescence, and there is a ventilated fluorescent area at the upper edge of the bleeding. The late neovascularization had leakage of fluorescein to form a strong fluorescent region.

Retinitis diagnosis and treatment

diagnosis

Eye symptoms are not obvious, mainly manifested as vision loss and even blindness. At the beginning of the disease, the pupils dilate and become dilated when they become chronic. Fundamental examinations are needed to confirm the diagnosis with a speculum: retinal edema, poor transparency, yellow or blue-gray exudation under the retinal blood vessels at the beginning of the disease, causing different degrees of bulging or peeling of the retina, venous bleeding in the patient, and small veins Bend due to expansion; Optic nerve papillae are congested, enlarged, and the outline is not clear. The edge of the nipple is unclear, and further development is atrophied, and the vitreous body is cloudy due to blood invasion. In the late stage of the disease, the blood vessels of the lesion are constricted, and the surface of the lesion appears grayish white and pale yellow. Or yellowish red mound-like bulges; chronic lesions can be seen with yellow-white deposits of cholesterol crystals.

treatment

When treating this disease, place the sick animals in a dark room, wear eye bandages, and keep quiet.

Prescription 1 Penicillin G, horses, cattle 0.5 to 10,000 iu / kg times, pigs, sheep, dogs 1 to 15,000 iu times. Intramuscular injection twice a day for 5-7 days.

Prescription 2 Streptomycin sulfate 10mg / kg twice daily, intramuscularly, for 5-7 days.

Prescription 3 Gentamicin sulfate, 1000 ~ 500iu / kg for horses, cattle, pigs, and sheep, 50mg / kg for dogs and cats, 2 times a day, intramuscular injection, for 5-7 days.

Prescription 4 spiramycin, 4 to 10 mg / kg for horses and cattle, 10 to 50 mg / kg for pigs and sheep, once a day, intramuscular injection, 5 to 7 consecutive days.

Prescription 5 0.5% procaine injection 1ml, streptomycin 0.2g, cortisone 2mg, injection under the conjunctiva.

Prescription 6 0.5% procaine hydrochloride injection 4ml, penicillin 100,000iu, dexamethasone sodium phosphate injection 1ml, 0.5 ~ 1ml injected subcutaneously on the upper and lower eyelids.

Prevention and treatment of retinitis

In the later stages of retinitis, retinal detachment, atrophy, cataract or glaucoma can be secondary. Antibiotics are applied throughout the body, and the eyes are closed (antibiotics + procaine + dexamethasone) to control the development of inflammation. The treatment of the primary disease is very important at the beginning of the disease. Eyes can be removed in severe cases.