The meaning of retinitis pigmentosa (RP) in retinitis pigmentosa

Retinitis pigmentosa (RP) refers to a disease that affects the retina and causes retinal function degeneration.

After nearly thirty years of repeated clinical practice, Director Yang Chunhua and Director Zhang Zhenyi, chief physicians of the Ophthalmology Department of the Second Hospital of the Beijing Armed Police, used Heller's arterial ring and vortex vein collateral circulation to establish retinitis pigmentosa. The efficiency reaches 95.6. The eye electrophysiological comparison test before and after surgery by Professor Cai Haoran, a doctoral supervisor at Peking University Vision Research Center, confirmed that the efficacy is significant. Heller's arterial ring vortex venous collateral circulation is based on the pathological changes of retinitis pigmentosa. Through surgery, the outer choroidal large vessels, the optic nerve leptomeningeal vascular network, the prelaminar and cribrosa areas of the optic disc, and the retinal sector area are The circulatory metabolism was significantly improved and the visual function was reversed. After early surgery (electroretinogram is not extinguished), vision can be greatly improved, the field of vision can be broadened, and the electroretinogram gradually returns to normal. For patients in the middle and advanced stages (retinal map shows a burn-out type, the computer visual field remains more than 10 degrees, and the central visual acuity is more than 0.1), the visual acuity is slightly improved after surgery, and the visual field is improved. There was no change in the electroretinogram. During a follow-up visit one year after the operation, the electrooculogram light peaks and dark troughs were improved.

The special research group led by Director Yang Chunhua and Director Zhang Zhenyi, after 27 years of painstaking research and unremitting exploration, carried out surgical treatment for the important intermediate link closely related between retinitis pigmentosa and abnormal choroidal microcirculation. intervention. It has improved the academic argument for using autologous blood vessels to establish collateral circulation in the treatment of retinitis pigmentosa. 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 process of basic theoretical research and clinical practice, with the support of Professor Cai Haoran, a doctoral supervisor at the Peking University School of Medicine and an expert in bioelectricity, through strict visual physiology of patients before and after surgery: electroretinography (F-ERG), electrooculogram ( The comparison of various parameters of EOG) and visual evoked potential (P-VEP) fully demonstrates the effectiveness of this surgery in the clinical treatment of patients with retinitis pigmentosa. The Ministry of Health's medical and health information search concluded that there are no similar treatment methods at home and abroad that can cause visual electrophysiological improvement in patients with retinitis pigmentosa. It has been confirmed that this unique medical service project is at the leading level in the field of ophthalmic medical treatment at home and abroad.

Retinitis pigmentosa is a difficult disease in ophthalmology, known as an incurable disease. It is a hereditary chronic eye disease originating from retinal dystrophy. It mostly affects both eyes. There are about 300,000 domestic patients. There are about 3 million people in the world. Its clinical characteristics include early night blindness, concentric narrowing of the visual field, and finally a tubular visual field. Blindness in both eyes or frequent blindness accounts for a considerable proportion of blind eye diseases. Retinitis pigmentosa (RP) is a hereditary rod and cone dystrophy disease. It is characterized by night blindness, reduced visual field, and osteocytoid pigmentation of the fundus. Over the past decades, many basic studies in the ophthalmology community at home and abroad have confirmed that retinitis pigmentosa is related to reduced choroidal blood flow. The formation of night blindness and tubular visual field indicates that the choroidal blood flow can no longer meet the metabolic needs of rod photoreceptor cells, which is related to the blood flow in the choriocapillaris region. This corresponds to a decrease in circulatory function. Our center has confirmed that after more than 3,000 patients from China, Japan, the United States, Germany, Kazakhstan, Myanmar, Mongolia, the Philippines, Canada and other countries performed autologous blood vessel harvesting to establish collateral circulation, early and middle-stage patients can be treated to varying degrees through surgical treatment. It improves vision, broadens the field of vision, and the total effective rate of fundus improvement reaches 96%; it can effectively prevent the progression of the disease and delay blindness in patients with advanced stages. Basic medicine drives the progress of clinical medicine. The clinical practice of surgery has verified that this surgical design is consistent with the research results of the ocular microcirculation theory at home and abroad. Retinitis pigmentosa is a congenital hereditary blinding eye disease originating from reticular choroidal dystrophy and characterized by retinal pigment epithelium and retinal dysfunction as its main clinical manifestations. The overall incidence rate in our country is about 1/4000, with more than 300,000 patients, and there are more than 3 million patients worldwide. The clinical manifestations are early night blindness, progressive narrowing of the visual field, and in severe cases, a tubular shape, and eventually central vision decreases and gradually leads to blindness or frequent blindness.

Once the patient was diagnosed with the disease (incurable disease), it caused great psychological damage to the patient, and at the same time cast a shadow on the happy family. The long journey of seeking medical treatment was frustrating. Exhausted mentally and physically, he could not escape the fate of blindness in the end. This project has gone through eighteen years of repeated clinical practice and achieved remarkable results, which were confirmed by contrastive ocular electrophysiological tests before and after surgery. After searching by the Institute of Medical Information of the Chinese Academy of Medical Sciences, it was concluded that there are no identical domestic and foreign literature reports on treatment methods that can cause improvement in eye electrophysiology. Although retinitis pigmentosa is a hereditary disease, retinal and choroidal microcirculation disorders play a crucial role in the occurrence and development of the disease. Chinese medicine calls this disease high-wind cataract and high-wind bird's eye, which is caused by insufficient congenital endowment. In the 1970s, Soviet ophthalmologists proposed improving choroidal microcirculation to treat this disease; in 1990, British ophthalmologists confirmed that retinitis pigmentosa is related to reduced choroidal blood flow; this theory was confirmed again in 1999 by Yang Wenli of Beijing Tongren Hospital and others using Doppler testing . According to the pathological changes of retinitis pigmentosa, the center used surgical treatment to establish collateral circulation, which significantly improved the circulation metabolism of the large blood vessels in the outer choroid and the retinal sector, and reversed the visual function. Create a new way to treat patients with retinitis pigmentosa.

Due to the continuous improvement of surgical techniques and the gradual improvement of auxiliary treatments, early-stage patients can improve their visual acuity and broaden their field of vision after surgery, and their electroretinograms gradually return to normal or accept normal; mid-stage patients can improve their visual acuity and field of vision after surgery. , the electroretinogram cannot be changed, but the light peak, dark trough, and Arden ratio of the electrooculogram of 60 patients have improved or been close to normal one year after surgery; in advanced patients, the progression of the disease can be effectively prevented after surgery. Experts from the center advise patients with retinitis pigmentosa to pay close attention to changes in electroretinogram and computer visual field graphics once a diagnosis is made, and must not delay treatment to cause irreversible damage to visual function. So far, 550 patients have been successfully treated, and all have achieved good results. Among them, 26 patients have been observed for 5-15 years. The long-term efficacy is significantly better than the short-term efficacy, and no complications have been found. Once patients with retinitis pigmentosa are diagnosed, they should pay close attention to the electroretinogram, computer visual field graphics and fundus changes, and perform timely surgery in the early and mid-term to avoid delaying treatment opportunities and causing irreversible damage to visual function, so as to strive for better curative effects. All the medical staff of our center will make unremitting efforts to provide the best possible medical services to patients with retinitis pigmentosa. Retinitis pigmentosa is one of the most serious eye diseases causing blindness today. Statistics from the American ophthalmology community show that in the 20- to 40-year-old age group, retinitis pigmentosa is the main cause of blindness. According to rough statistics, there are approximately 1.5 million patients with retinitis pigmentosa worldwide. This astonishing number is not decreasing year by year, but increasing day by day. Isn’t this enough to attract the attention of the world!? In the early stage of retinitis pigmentosa, there are only symptoms of night blindness, which does not affect work, study and normal life at all, and the disease is unknown. Unknowingly damaging vision. Especially for children in early childhood, early detection is even more difficult. The retina has a delicate structure and complex functions. The intraspherical tissue in the posterior segment of the eyeball cannot be seen with the naked eye. In 1851, Helmhotz invented the ophthalmoscope, and the fundus changes of retinitis pigmentosa were revealed. Still, treatment remains empty talk. It was not until the 1970s that retinitis pigmentosa attracted the attention of Western developed countries. This disease was discovered in my country in the early Qing Dynasty, when it was called bird cataract. As the name suggests, it's appropriate. The name of the disease is good, and it also explains the basis for dialectical treatment, such as: focusing on strengthening the spleen and replenishing qi, adding prescriptions for soothing the liver and activating blood circulation, combined with acupuncture, massage, qigong and nourishing drugs, etc. Some of the prescriptions are still used today. in use.

Medical genetics is the main component of human genetics. It is a border science that combines genetics and medicine. It provides diagnosis, treatment, and prevention by exploring the relationship between the occurrence and development of human diseases and genetic factors. scientific basis for hereditary diseases, thereby contributing 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 genetic diseases have exceeded There are 5,000 species, posing a great threat to human life and health. However, with the rapid development of modern high-tech, basic medicine, especially research on immunology, molecular biology and genetics, is also advancing in depth and breadth. Among them, cytogenetics and molecular genetics are studied at the cellular level and molecular level. It is developing even more rapidly, making genetic diagnosis and gene therapy of some hereditary diseases more possible. For example, cells are removed from the patient's body and genetically modified, and then reinjected into the body to artificially change abnormal genes to prevent and treat genetic diseases; a research institution at Boston University in the United States injects a gene that controls the secretion of vascular endothelial growth hormone. , a gene that instructs the body to grow new blood vessels. The achievements in molecular genetics research and the results obtained in manipulating human gene combinations have made it possible to use recombinant DNA technology to treat diseases. Although this kind of genetic engineering is still in the exploratory and experimental stage, it is expected to transform human beings within a few years. The DNA sequence of 100,000 genes on chromosomes has been clarified, and a complete human genome map has been drawn - the blueprint of life. I believe this is a directional and essential measure. Along with advances in immunogenetics and surgery, the prospects for treating difficult-to-treat genetic diseases such as retinitis pigmentosa are encouraging. The great French poet Goethe said: All I have to do is reach out and reap the crops that others have sown for me. What I do is to sort out the fruits harvested by others and then offer them to readers. Due to our limited level, little experience, and lack of information at hand, there will be many mistakes. We kindly ask our fellow ophthalmologists and readers to correct them. We would like to express our gratitude. Our purpose of establishing this scientific research website is to call all sectors of society to pay attention to the genetic disease of retinitis pigmentosa, provide as much support and help to patients with the disease as possible, and raise people's awareness of retinitis pigmentosa. At the same time, we call on our ophthalmology colleagues to carry out scientific research collaboration and website exchanges, so that more RP patients can effectively control their condition and receive satisfactory treatment. If patients with retinitis pigmentosa can get some inspiration from our website, muster up the courage to live, and realize that the colorful world will never leave you, then we will be extremely happy. In the literature, vasodilators, vitamins A and B1, tissue therapy, various hormones, Chinese herbal medicine, acupuncture and other methods have been tried, which may prevent the rapid deterioration of visual function.