Retinal Degeneration: Causes, Treatments, and Prevention Tips

Retinal diseases

Hello Doctor: I am highly myopic and have been feeling something unusual in my left eye for a while.
The colors I see with my left eye seem slightly duller than those with my right eye.
When I look at white objects, they appear to have a faint yellowish film in my left eye.
I am worried that it might be related to macular degeneration.
I underwent an electroretinogram and fluorescein angiography, and the doctor at the major hospital said that my retina and macula are fine, but there is some degeneration of the pigment cells in both eyes, with the left eye being more affected.
This is related to my ankylosing spondylitis, and I need to continue my medication with the immunology department; otherwise, my vision may worsen in five years.
However, I have been diligently taking my medication...

1.
Besides autoimmune factors, are there any other factors that could cause degeneration of the pigment cells?
2.
Are the pigment cells referring to retinal pigment epithelial cells, and if so, does that count as retinal degeneration?
3.
Are there any other treatments or preventive measures available? Would taking lutein be beneficial? Thank you, Doctor.

Chen, 20~29 year old female. Ask Date: 2017/09/15

Dr. He Jianxian reply Ophthalmology

1.
Many people actually experience degeneration of the retinal pigment epithelium, especially in the elderly, and the causes are often unknown.
2.
The retinal pigment epithelium is located outside the neural cell layer of the retina, but its degeneration can indeed affect the neural cell layer.
3.
There is no significant benefit from consuming lutein, and currently, there are no effective treatments available.

Reply Date: 2017/09/15

More Info

Understanding retinal degeneration is crucial, especially for individuals with conditions like high myopia, which can significantly increase the risk of various retinal issues. Retinal degeneration can manifest in several forms, including age-related macular degeneration (AMD), retinal pigmentosa, and other degenerative diseases. In your case, the concern about color perception differences between your eyes and the potential for retinal pigment cell degeneration is valid and warrants careful consideration.

Causes of Retinal Degeneration
1. Genetic Factors: Certain inherited conditions can predispose individuals to retinal degeneration. For example, retinitis pigmentosa is a genetic disorder that leads to the progressive degeneration of the retina.

2. Age: As individuals age, the risk of developing retinal degeneration increases. Age-related macular degeneration is one of the leading causes of vision loss in older adults.

3. High Myopia: Individuals with high myopia are at a higher risk for retinal detachment and degeneration due to the elongation of the eyeball, which can stretch and thin the retina.

4. Systemic Diseases: Conditions such as autoimmune diseases (like ankylosing spondylitis, which you mentioned) can impact retinal health. Inflammatory processes can lead to changes in the retinal structure and function.

5. Environmental Factors: Prolonged exposure to UV light, smoking, and poor diet can contribute to retinal degeneration. Antioxidants found in fruits and vegetables are believed to help protect retinal cells.

Understanding Retinal Pigment Cells
Yes, the term "pigment cells" typically refers to retinal pigment epithelial (RPE) cells, which are crucial for the health of photoreceptors in the retina. These cells play a vital role in the visual cycle, helping to recycle visual pigments and providing structural support to photoreceptors. Degeneration of these cells can lead to impaired vision and is indeed considered a form of retinal degeneration.

Treatment and Prevention Strategies
1. Regular Monitoring: Given your history and the potential for progression, regular follow-ups with your ophthalmologist are essential. They can monitor changes in your retinal health and adjust your treatment plan as necessary.

2. Medication Compliance: Continue adhering to the medication prescribed by your rheumatologist. Immunosuppressive therapy can help manage autoimmune conditions and potentially slow the progression of associated retinal degeneration.

3. Dietary Considerations: While there is no definitive cure for retinal degeneration, a diet rich in antioxidants (like vitamins C and E, beta-carotene, and zinc) may support retinal health. Foods high in omega-3 fatty acids, such as fish, can also be beneficial.

4. Supplements: Lutein and zeaxanthin, often found in eye health supplements, are believed to support retinal health. However, the evidence regarding their effectiveness in preventing retinal degeneration is mixed. It's best to discuss any supplementation with your healthcare provider.

5. Protective Eyewear: Wearing sunglasses that block UV light can help protect your eyes from harmful rays, which may contribute to retinal damage over time.

6. Lifestyle Modifications: Avoid smoking and manage other health conditions (like hypertension and diabetes) that can exacerbate retinal issues. Regular exercise and maintaining a healthy weight can also be beneficial.

Conclusion
In summary, while retinal degeneration can be concerning, understanding its causes and implementing preventive measures can help manage the risk. Regular check-ups, adherence to treatment, and a healthy lifestyle are key components in maintaining your vision. If you have further questions or concerns, don't hesitate to reach out to your healthcare provider for personalized advice tailored to your specific situation.

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