Sheri linad-Retinitis Pigmentosa-(Venezuela)-Posted on October 13, 2014

Name: Sheri linad 
Sex: Female
Country: Venezuela
Age:61 years
Diagnoses: Retinitis Pigmentosa , Hyperlipidemia
Date: September 2, 2014
Days Admitted to Hospital: 21 days

Before treatment:
The patient's family member found out that the patient's walking was unstable which was accompanied with blurred vision. She went to a local hospital and was diagnosed with Retinal pigment degeneration. But she didn't received special treatment. The disease aggravated gradually. Before the treatment, the patient suffered from loss color vision. She had difficulty with distinguishing gradient Color. She also had difficulty to distinguish deep or shallow color. Both visions were poor. She could distinguish fingers. Left eye's vision was slightly better than right eye. Both eyes presented with tubular visual field. She suffered from visual field defect.

From onset of disease, the patient had normal spirit. Her weight was normal. The diet and sleep were normal. The defecation and urine were normal. There was similar cases in her family.

Admission PE:
 Bp: 115/80mmHg; Hr: 82/min, Br: 20/min. The patient's development was normal. She was thin. The mucosa was intact. The thorax was symmetrical; the respiratory sounds of both lungs were clear, with no moist rales. The heart sound was strong. The rhythm of her heart was regular, and there was no obvious murmur in the valve area. The abdomen was recessed and soft, with no masses. Through palpation, the liver and spleen were found to be normal. There was no swelling in both lower limbs.

Nervous System Examination: 
Sheri linad was alert and her speech was clear. Her calculation, memory and orientation were almost normal. Both pupils were equal in size and round, the diameter was 4.0mms. Both pupils were sensitive to direct light and consensual. The color vision declined slightly. She had difficulty to distinguish similar colors. She also had difficulty with distinguishing deep and light color objects. Both visions were poor. She could distinguish the number of fingers, left eye was better than right eye. From a distance of 3 meters (3-meter distance of standard visual acuity chart), the vision: right eye was 0.08, left eye 0.1. From a distance of 1 meter, vision: right eye 0.08, left eye 0.2. There was tubular vision and visual field defect. Both eyes could move freely to each sides. There was obvious horizontal and vertical nystagmus. There was pigmentation in retinal fundus. Both retina presented with light yellow. The forehead wrinkle pattern was symmetrical, the nasolabial sulcus was equal in depth, the teeth were symmetrical and the tongue was centered in the oral cavity. There was flexible movement in the neck. The muscle tone of all four limbs was almost normal; the muscle strength of all four limbs was at level 5. The tendon reflex of her four limbs was normal. The abdominal reflexes were normal. The sucking reflex, palm and jaw reflex were negative. Bilateral Hoffmann sign was negative. The pathological reflex of four limbs was negative. She had normal deep and shallow sensation. The coordinate examination was normal. There was no meningeal irritation sign.

Treatment: 
We gave Sheri linad a complete examination, she was diagnosed with Retinal pigment degeneration and Hyperlipidemia. The patient received treatment for retina and optic nerve regeneration and to activate stem cells in vivo. She received treatment to improve the blood circulation in order to increase the blood supply and nourish the damaged neurons. She also received treatment to adjust her blood lipid.

Post-treatment:
The patient's blood lipid has been restored to normal level. The vision, visual field and fundus have all improved. Specific information as follows:

 Visual field change: From a distance of 1 meter, left eye's above visual field and lower visual field has enlarged about 3-4cm, left eye's left visual field and right visual field has enlarged about 2-3 cm. Right eye's above visual field and lower visual field has enlarged about 4 - 5 cm, right eye's left visual field and right visual field has enlarged about 3 - 4cm. The horizontal and vertical nystagmus has reduced.
Fundus changes: The arteriovenous ratio of blood vessel in fundus was near 2:3.  The color of retina in both eyes has obvious improvement, has changed from light yellow to dark red color. Peripheral pigmentation has reduced.