视网膜色素变性治疗的研究进展

视网膜色素变性(retinitis pigmentosa,RP)是由视网膜光感受器和视网膜色素上皮变性所引起的致盲性、遗传性眼病,目前尚无有效的治疗方法,相关治疗研究还处于探索阶段,如基因治疗、药物治疗、移植治疗、人工视网膜假体等。基因治疗RP是目前的研究热点,包括修复致病基因、核酸治疗、RNA干扰技术等。基因治疗、干细胞移植、人工视网膜假体治疗RP已经进入临床试验阶段,为治疗该病带来了新的希望。本文就RP治疗的研究进展做一综述。     

兔胚胎全层视网膜移植至大鼠视网膜下的观察

视网膜色素变性(RP)是一组能导致进行性感光细胞变性和视觉障碍的遗传病症候群，目前尚无有效治疗方法。近年来研究表明视网膜移植是最接近临床应用治疗RP的方法。当RP进展到晚期，感光细胞和视网膜色素上皮(RPE)细胞都出现变性死亡，单独移植这两种成分都没有作用，此时病变视网膜的修复需要全层视网膜的移植。我们将青紫蓝兔胚胎全层视网膜移植到正常Wistar大鼠和视网膜变性RCS大鼠的视网膜下腔，观察移植物在宿主视网膜下腔的发育状况，从而探讨异种胚胎全层视网膜移植方法的可行性。     

视网膜色素变性新疗法的评估

视网膜色素变性（RP）是一种眼科常见的遗传性疾病，预后往往不佳。近年来，随着基因治疗，视网膜移植，神经远祖细胞移植，视网膜细胞营救等技术的广泛开展和完善，给RP病的治疗带来了新的希望。本现就RP病治疗的研究现状和前景，以及各种方法的特点做一理论分析。     

视网膜色素变性的治疗进展

视网膜色素变性(RP)是一组以进行性感光细胞及色素上皮细胞功能丧失为共同表现的遗传性视网膜疾病.临床表现为夜盲,伴有进行性视野缺损,眼底色素沉着和视网膜电流图异常.近年对该病治疗上有一些研究.文中介绍了应用基因治疗、细胞移植、药物、人工视觉等方面治疗RP的一些进展.     

用科学的态度正确认识视网膜色素变性

视网膜色素变性(RP)是最常见的遗传性致盲眼底病,具有高散发性和高临床异质性.除了常见的遗传类型外,还具有双基因遗传,线粒体遗传,不完全显性遗传等新遗传方式.RP的表型复杂,Peripherin/RDS、RHO、RP2和RP3等RP基因出现了基因型和表型不一致现象,中心性、单发性、无色素性和缓慢型视网膜变性等少见RP具有复杂的临床表型.视网膜移植术、视网膜植入术、药物及神经营养因子治疗和基因治疗等治疗体系已经建立.但是,一些眼科医师对于RP治疗的新进展和新知识了解不多,因此积极地更新知识,以科学的态度正确地认识RP非常必要.(中华眼科杂志,2009,45:193-195)     

视网膜移植治疗视网膜色素变性的研究进展

视网膜色素变性 (RP)是一种遗传性眼病 ,目前尚无切实有效的治疗方法 ,视网膜移植是最有前景的治疗措施。本文就视网膜移植治疗视网膜色素变性的方法学、免疫学、解剖学及临床研究进展作一综述     

视网膜色素变性新疗法的评估

视网膜色素变性 (RP)是一种眼科常见的遗传性疾病 ,预后往往不佳。近年来 ,随着基因治疗、视网膜移植、神经远祖细胞移植、视网膜细胞营救等技术的广泛开展和完善 ,给RP病的治疗带来了新的希望。本文现就RP病治疗的研究现状和前景 ,以及各种方法的特点做一理论分析     

视网膜色素变性治疗研究进展

视网膜色素变性(retinitis pigmentosa,RP)是一组遗传性视网膜疾病,其特征是渐进性感光细胞和视网膜色素上皮(RPE)细胞功能障碍,是世界范围内常见的致盲性眼病,且缺乏有效的治疗方法。目前RP的治疗方法包括干细胞治疗、基因治疗、神经保护治疗、营养疗法、高压氧疗法、视网膜移植和中医治疗。本文综述了近年来国内外有关RP治疗的研究进展。     

碱性成纤维细胞生长因子治疗视网膜变性进展

视网膜色素变性(retinitis pigmentosa,RP)是世界上最常见的遗传性致盲疾患之一。目前的研究表明，碱性成纤维细胞生长因子(basic fibroblast growth factor,bFGF )可以挽救视网膜光感受器的变性。现将 bFGF的来源、生物学活性、在治疗视网膜变性疾病机制方面的研究进展以及采用bFGF基因转移治疗RP的研究现状等综述如下。(中华眼底病杂志，2002，18：167-168)     

视网膜色素变性患者的多焦视网膜电图与视网膜光学相干断层扫描的观察分析

目的研究视网膜色素变性(RP)患者的多焦视网膜电图(mERG)与视网膜光学相干断层扫描(OCT)的特性及图像特征。方法对已确诊的6例(12只眼)原发性视网膜色素变性患者和10例(20只眼)正常人的视网膜进行多焦视网膜电图与视网膜光学相干断层扫描检查,并对所得数据进行统计分析。结果RP患者视网膜黄斑中心凹厚度平均值低于正常人,但两者之间无显著差异性,RP患者OCT的视网膜断层反射像与正常反射像相比有较明显的改变;RP患者的多焦视网膜电图各环的反应密度均低于正常人,且有显著性差异,4~6环的潜伏期与正常人相比显著延长。结论多焦视网膜电图可有效地评价RP患者黄斑区及周边视网膜的功能,RP患者OCT的断层扫描像与其已知的视网膜病变特点相一致。     

Molecular genetics and emerging therapies for retinitis pigmentosa: Basic research and clinical perspectives

Retinitis Pigmentosa (RP) is a hereditary retinopathy that affects about 2.5 million people worldwide. It is characterized with progressive loss of rods and cones and causes severe visual dysfunction and eventual blindness in bilateral eyes. In addition to more than 3000 genetic mutations from about 70 genes, a wide genetic overlap with other types of retinal dystrophies has been reported with RP. This diversity of genetic pathophysiology makes treatment extremely challenging. Although therapeutic attempts have been made using various pharmacologic agents (neurotrophic factors, antioxidants, and anti-apoptotic agents), most are not targeted to the fundamental cause of RP, and their clinical efficacy has not been clearly proven. Current therapies for RP in ongoing or completed clinical trials include gene therapy, cell therapy, and retinal prostheses. Gene therapy, a strategy to correct the genetic defects using viral or non-viral vectors, has the potential to achieve definitive treatment by replacing or silencing a causative gene. Among many clinical trials of gene therapy for hereditary retinal diseases, a phase 3 clinical trial of voretigene neparvovec (AAV2-hRPE65v2, Luxturna) recently showed significant efficacy for RPE65-mediated inherited retinal dystrophy including Leber congenital amaurosis and RP. It is about to be approved as the first ocular gene therapy biologic product. Despite current limitations such as limited target genes and indicated patients, modest efficacy, and the invasive administration method, development in gene editing technology and novel gene delivery carriers make gene therapy a promising therapeutic modality for RP and other hereditary retinal dystrophies in the future.     

Review and update: Current treatment trends for patients with retinitis pigmentosa

BackgroundRetinitis pigmentosa (RP) is a heterogeneous group of inherited retinal disorders characterized by progressive photoreceptor apoptosis. It is the leading cause of inherited retinal degeneration–associated blindness. RP has a unique set of clinical characteristics that make it a complex disease associated with distinct inheritance patterns. An understanding of the pathogenesis is essential in the process of the differential diagnosis and the development of treatment options. Recent developments in research are likely to expand the various therapeutic modalities to include gene therapy, pharmacologic treatment, cell transplantation, and neuro-prosthetic devices.MethodsA literature search was performed to comprehensively review RP diagnosis, pathophysiology, and treatment.ConclusionAdvances in the understanding of the pathophysiology of RP are creating new opportunities for the treatment of this often visually debilitating eye condition. Optometrists, as primary eye care practitioners, should be aware of the inheritance, pathophysiology, and current treatment options for RP as well as treatments in development so that they can best care for their patients with inherited retinal disorders.     

In depth understanding of retinitis pigmentosa pathogenesis through optical coherence tomography angiography analysis: a narrative review

Retinitis pigmentosa (RP) is the most recognized inherited retinal disorder involving progressive photoreceptors degeneration which eventually causes blindness. However, the pathogenesis of RP is still unclear, making it difficult to establish satisfying treatments. Evidence have been found to support the theory that vascular dysfunction is associated with the progression of RP. Optical coherence tomography angiography (OCTA) is a newly developed technology that enables visualization as well as quantitative assessment of retinal and choroidal vasculature non-invasively. Advances in OCTA have opened a window for in-depth understanding of RP pathogenesis. Here, we propose a hypothesis of RP pathogenesis based on the current OCTA findings in RP, which includes four stages and two important key factors, vascular dysfunction and microglia activation. Further, we discuss the future animal experiments needed and how advanced OCTA technology can help to further verity the hypothesis. The final goal is to explore potential treatment options with enhanced understanding of RP pathogenesis.     

New drug therapy for retinal degeneration

Retinitis pigmentosa (RP) is an inherited retinal degeneration characterized by nyctalopia, ring scotoma, and bone-spicule pigmentation of the retina. So far, no effective therapy has been found for RP. As a possible molecular etiology of RP, retina-specific gene deficits are most likely involved, but little has been identified in terms of intracellular mechanisms leading to retinal photoreceptor cell death at post-translational levels. In order to find an effective therapy for RP, we must look for underlying common mechanisms that are responsible for the development of RP, instead of designing a specific therapy for each of the RP types with different causes. Therefore, in the present study, several animal models with different causes of RP were studied, including (1)Royal College of Surgeons (RCS) rats with a deficit of retinal pigment epithelium (RPE) function caused by rhodopsin mutation; (2) P23H rats, (3) S334ter rats, (4) photo stress rats, (5) retinal degeneration (rd) mice with a deficit of phosphodiesterase(PDE) function; and (6) cancer-associated retinopathy (CAR) model rats with a deficit of recoverin-dependent photoreceptor adaptation function. In each of these models, the following assessments were made in order to elucidate common pathological mechanisms among the models: (1) retinal function assessed by electroretinogram (ERG), (2) retinal morphology, (3) retinoid analysis, (4) rhodopsin regeneration, (5) rhodopsin phosphorylation and dephosphorylation, and (6) cytosolic cGMP levels. We found that unregulated photoreceptor adaptation processes caused by an imbalance of rhodopsin phosphorylation and dephosphorylation caused retinal dysfunction leading to photoreceptor cell death. As possible candidate drugs for normalizing these retinal dysfunctions and stopping further retinal degeneration, nilvadipine, a Ca channel blocker, retinoid derivatives, and anthocyanine were chosen and tested to determine their effect on the above animal models with retinal degeneration. Nilvadipine showed beneficial effects against retinal degeneration in all models tested, but retinoid derivatives and anthocyanine showed these beneficial effects in only some models. Thus our present data allowed us to test the effectiveness of nilvadipine in the treatment of human RP patients.     

An eight-year experience of cryotherapy of acrive retinal retinopathy in prematures: management of patients and results

The paper represents an eight-year experience of active retinopathy of prematures (RP) by the method of transscleral cryopexy of the retinal zone in 91 patients (181 eyes) The time period and periodicity of ophthalmologic follow-up of prematures with RP risk are defined; indication and contraindications for cryotherapy are formulated; complications observed at the early postoperative period are pointed out. Cryotherapy was shown to be an effective method of treatment in RP: favorable treatment results were registered in 54.5% of cases. There are also results of a comparative analysis of the clinical refraction condition observed in RP patients in 4.8-5 years after cryotherapy. Myopia was by far more often diagnosed in the group of RP patients (38.2%). This parameter made 12% (p < 0.001) in the group of equal prematures.     

Retinal regeneration and stem cell therapy in retinitis pigmentosa

Retinitis pigmentosa (RP) is the leading cause of hereditary blindness, and there is currently no available treatment that can either significantly slow the progression of this disease or restore lost vision. Amphibians and birds exhibit different strategies for retinal regeneration, including the proliferation of cells in the ciliary margin and transdifferentiation of the retinal pigment epithelium (RPE) and Muller glia. The mammalian retina does not have the innate ability to regenerate damaged retina, but research is actively exploring pathways that promote endogenous regeneration. Because the inner retinal architecture is largely preserved, even in advanced cases of RP, an alternative is to replace the degenerated photoreceptor cells, thereby replenishing the photoreceptor population. The transplantation of embryonic stem cells, induced pluripotent stem cells, embryonic retinal progenitors (postmitotic photoreceptor precursors), and hippocampal neuronal progenitors have been investigated for this purpose. The encouraging results demonstrate the integration and possible functional connection between the transplanted cells and the inner retinal circuitry of the host. In this review, we summarize recent advancements in this field and their potential for the treatment of RP and other retinal degenerations.     

骨髓间充质干细胞在视网膜色素变性大鼠视网膜下的分化

目的:研究骨髓间充质干细胞（MSC）在视网膜色素变性（RP）大鼠体内的分化。方法:Lewis大鼠腹腔注射30g/L NaIO₃ 100mg/kg,建立大鼠RP模型,将体外培养的MSC植入视网膜下腔,用免疫荧光标记的方法对MSC进行追踪,并观察术后第1,2,3,4,5wk MSC在该微环境中的分化。结果:术后第1wk即可见MSC位于视网膜色素上皮（RPE）层与光感受器细胞层,但全角蛋白（PCK）及rhodopsin标记阴性,第3wk开始可见MSC在体内表达PCK及rhodopsin。结论:MSC植入RP模型大鼠视网膜下腔后可存活,主要分布于RPE层和视锥、视杆细胞层,并表达RPE细胞和光感受器细胞的表面标志。     

视网膜色素变性研究新进展

视网膜色素变性(retinitis pigmentosa,RP)也称为色素性视网膜炎。RP是由于视网膜色素上皮细胞功能逐渐丧失及光感受器进行性凋亡从而导致不可逆的视力损伤的一组遗传性眼病。因其表型和遗传均具有异质性,发病机制复杂,目前尚无单一有效的治疗方法。本文报告近年来RP在诊疗方面的进展。