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Retinitis Pigmentosa Follow-up

  • Author: David G Telander, MD, PhD; Chief Editor: Hampton Roy, Sr, MD  more...
 
Updated: Feb 17, 2015
 

Further Outpatient Care

Annual patient examinations usually are sufficient to measure Goldmann visual field and visual acuity.

If medical treatment is initiated, more frequent visits and laboratory blood work may be indicated.

Patients with systemic conditions that are associated with retinitis pigmentosa (RP) may require closer follow-up care.

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Inpatient & Outpatient Medications

See Medical Care and Medication.

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Prognosis

See Mortality/Morbidity.

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Patient Education

To help them make wise decisions about driving or vocational rehabilitation, educate patients about their field defects.

Family pedigrees and, when available, genetic subtyping can be helpful in genetic counseling. Patients should understand that the visual degeneration, which usually occurs over 30-40 years, slowly progresses and varies with the type of RP.

Patients with Usher syndrome should understand the course of their hearing loss, as each of the 3 types of Usher syndrome has a different prognosis regarding hearing.

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Contributor Information and Disclosures
Author

David G Telander, MD, PhD Ophthalmologist, Vitreo-Retinal Diseases and Surgery, Retinal Consultants Medical Group; Volunteer Clinical Faculty, Department of Ophthalmology, University of California Davis School of Medicine

David G Telander, MD, PhD is a member of the following medical societies: American Academy of Ophthalmology, American Medical Association, American Society of Cataract and Refractive Surgery, Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

Coauthor(s)

Anthony de Beus, MD, PhD Consulting Staff, Southwest Eye Centers

Anthony de Beus, MD, PhD is a member of the following medical societies: American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology

Disclosure: Nothing to disclose.

Kent W Small, MD Director/President, Macular and Retinal Disease Center; President, Molecular Insight LLC; Consulting Surgeon, Glendale Eye Medical Group

Kent W Small, MD is a member of the following medical societies: American Academy of Ophthalmology, American Association for the Advancement of Science, American Association for Physician Leadership, American Medical Association, American Medical Informatics Association, American Ophthalmological Society, American Society of Human Genetics, Association for Research in Vision and Ophthalmology, California Medical Association, Macula Society, Retina Society, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Specialty Editor Board

Simon K Law, MD, PharmD Clinical Professor of Health Sciences, Department of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology, American Glaucoma Society

Disclosure: Nothing to disclose.

Steve Charles, MD Director of Charles Retina Institute; Clinical Professor, Department of Ophthalmology, University of Tennessee College of Medicine

Steve Charles, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Retina Specialists, Macula Society, Retina Society, Club Jules Gonin

Disclosure: Received royalty and consulting fees for: Alcon Laboratories.

Chief Editor

Hampton Roy, Sr, MD Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy, Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Additional Contributors

Russell P Jayne, MD Consulting Vitreoretinal Surgeon, The Retina Center at Las Vegas

Russell P Jayne, MD is a member of the following medical societies: American Medical Association, American Society of Cataract and Refractive Surgery, American Society of Retina Specialists

Disclosure: Nothing to disclose.

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Usher syndrome with typical retinitis pigmentosa appearance.
Choroideremia.
Bull's eye maculopathy seen in cone dystrophy.
Polydactyly seen in Bardet-Biedl syndrome (associated with retinitis pigmentosa).
Cone dystrophy.
Gross pathology of an eye in a man with retinitis pigmentosa.
Leber congenital amaurosis.
Female carrier of choroideremia.
Representative electroretinograms of patients with healthy eyes, rod-cone dystrophy, and congenital stationary night blindness. Courtesy of Dr. Nusinowitz, Jules Stein Eye Institute.
Representative electroretinograms of patients with healthy eyes and X-linked retinoschisis. Courtesy of Dr. Nusinowitz, Jules Stein Eye Institute.
Retinitis pigmentosa pigmentation pattern demonstrated with ultrawide fundus imaging using the scanning laser ophthalmoscope (Optomap; Optos PLC, Dunfermline, Scotland, United Kingdom).
Fellow eye of same patient as in the image above, again demonstrating a typical retinitis pigmentosa pigmentation pattern demonstrated with ultrawide fundus imaging using the scanning laser ophthalmoscope (Optomap; Optos PLC, Dunfermline, Scotland, United Kingdom).
Higher resolution image of typical bone spicule formation.
Cone dystrophy demonstrating typical central macular atrophy found in this condition.
Retinitis pigmentosa, rubella, a history of retinal detachment, and syphilis all may result in a hyperpigmented retinal pigment epithelium (RPE) with bone spicule appearance, restricted visual field and/or poor vision, and atrophic vessels.
Retinitis pigmentosa progresses over decades. Associated cataract also is relevant, as seen in this image.
Pigmentary changes are not always seen in retinitis pigmentosa but frequently are observed, as in this patient with Alström disease.
Genetic screening may be helpful in identifying patients who are at risk, in counseling, and in directing treatment as new knowledge is acquired. Some varieties of retinitis pigmentosa may have increased vulnerability to environmental hazards; for example, one might avoid light exposure in some rhodopsin mutations or sildenafil in phosphodiesterase mutations. Patients with retinitis pigmentosa may have other findings. This patient with Alström disease shows acanthosis.
 
 
 
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