Driving home from your office, I could see my wife sitting next to me in the car, not just her hand on the steering wheel. There were cows by the side of the road. I could even see what color they were. My night vision improved, too. 57 year old man with retinitis pigmentosa.

Retinal Protective Therapy (RPT) improves the health and function of the retina in virtually every situation. This includes retinal diseases that are inherited. 

“Now I can see the utensils in the kitchen drawer, and not have to feel around for them like I used to. I could see and recognize people’s faces at a party. I haven’t been able to do that for years. The other day, I ran late and was able to drive comfortably at dusk instead of calling someone to come get me.” 60 year old woman with Stargardt’s disease.

Retinitis pigmentosa results from one of more than 150 possible gene abnormalities that lead to gradual loss of peripheral vision, night vision, and eventually all vision.  In Stargardt’s disease and Cone Degenerations, the inheritance and gene abnormalities are entirely different. In these, blindness is rare; but legal blindness (loss of central vision) is common.

“Everything is brighter and sharper. I can read better on my ipad.” 45 year old man with Usher’s syndrome.

Tests of retinal and visual function are generally abnormal in inherited retinal degenerations. Worsening of these tests tends to predict future visual loss. RPT can improve the results of retinal and visual function testing in inherited retinal degenerations. By so doing, it is hoped that disease progression can be slowed by RPT and the risks of vision loss reduced.  Over many years, even a small reduction in the rate of disease progression can significantly reduce the risk of visual loss. By restoring function to parts of the retina not previously working, RPT Retinal Activation may actually reverse the disease process in some cases. 

The goal of RPT in inherited retinopathies is improve retinal function in hopes of slowing disease progression. Patients may or may not notice improvement in their vision despite improvements in their testing results. If your visual loss is substantial, RPT can not restore normal vision. Instead, it may improve the vision that you have. Some patients report improvement within 24 hours after treatment. Peripheral vision, night vision, and visual acuity can be improved, at times to levels not previously enjoyed for years. By 6 weeks, many also note that these improvements begin to wear off. This is faster than in other retinal diseases. However, by repeating treatment every 6-8 weeks, clinical experience thus far suggests these improvements can be maintained. 

“That night I could see stars again for the first time and 10 years. When I got home, I could walk through the house without all of the lights on.” 27 year old woman with retinitis pigmentosa.

 

 

Stargardt’s Disease

Visual field tests of patient with Stargardt’s disease. Left side, before SDM RPT. Right side, one month after SDM RPT. Note improvement in visual function by all testing indices.

Retinits Pigmentosa

How RP affects vision

How things look with Stargardt’s disease.

Visual field test of patient with RP before (left) and 2 weeks after (right) RPT. “Driving home, I could see stars for the first time in 10 years. When I got home, I could walk through the house without every light on.”

Visual field test before (left) after (right) RPT for RP.
Note enlargement of the visual area.

Visual field test before (left) and 2 weeks (right) after RPT for Stargardt’s disease. “Everything is clearer and brighter. I can recognize faces again at parties. I can see utensils in the kitchen drawer again, without feeling for them. I was able to drive at dusk for the first time in years.”

This patient with RP returned 18 months after initial RPT, reporting that the treatment was wearing off in his left eye. RPT was repeated. Visual field before (left) and one day after (right) retreatment with RPT. “My peripheral vision and night vision came right back”.

The scientific paper “Improved retinal and visual function following panmacular subthreshold diode micropulse laser (SDM) in retinitis pigmentosa” published February 15, 2018 in the journal Eye,  is the first to report clinically effective treatment for RP.

We would like to perform a larger, nationwide study to confirm the findings of this first clinical study and this potentially important treatment. Please contact Dr. Luttrull if you, or your organization, have the interest and ability to sponsor / fund this very important study.

Should you wait for treatment until such a “randomized prospective clinical trial” is completed? Even if such a study were begun tomorrow, the results would not be available for many years. The safety of SDM RPT, the published results, and the rapidly progressive nature of RP suggest it is reasonable to begin treatment now.