Ruben Carlos Donato-Retinal Detachment-(Argentina)

Name: Ruben Carlos Donato
Sex: Male
Nationality: Argentinean
Age: 63Y
Diagnosis: 1. Retinal detachment 2. Hypothyroidism
Discharge Date: 2019/09/02

Before treatment:
The patient's right eye had poor visual acuity 19 years ago with retinal detachment and blindness. Three operations were performed that year. The postoperative visual acuity was not improved, there was no visual acuity and no light reflex. The left eye developed symptoms ten years ago. After 12 surgeries the visual acuity remained 20% and the light reflex was weak. The bilateral intraocular pressure was low and the patient used elevated intraocular pressure drugs to maintain intraocular pressure. At present the bilateral pupil of the patient is asymmetrical, the diameter of the left pupil is 5mm, and the visual acuity is retained at 20%. The number of fingers can be distinguished at around 30cm, the outline of larger objects can be distinguished within three meters and the outline of facial features can be seen within one meter. The diameter of the pupil in the right eye is 6mm, there is no light sensation and there is no pupil reflex to the light.
His spirit is good, he has poor diet and sleep, normal urination and defecation functions. He has hypothyroidism.

Admission PE:
Bp: 140/92mmHg, breathing rate 18/min, heart rate 72/min, body temperature: 36 degrees, height, 180cm; weight, 95kg. The patient has good nutrition with normal physical development. There were no yellow stains or bleeding spots of the skin or mucosa, a symmetrical chest, clear respiratory sounds of both lungs, no dry or moist rales heard, strong heart sounds, regular heart rhythm and no obvious murmur heard in valves. He has a flat and soft abdomen, no masses, a normal liver and spleen.

Nervous System Examination:
The patient was alert, had clear speech, normal memory, calculation and orientation abilities  with normal intelligence. He had slight denting of the eyeballs, low intra-ocular pressure bilaterally (5 mmHg), cloudy crystalline of the right eye with taupe gray color and no light perception, asymmetric pupils with irregular shapes. The pupil diameter of the right eye is 6mm, without light perception and no light response was observed. The pupil diameter of the left eye is 5mm, with tardy light response and only 20% vision left, being able to discern fingers at around 80cm, discern bigger objects’ shapes within 3m and see facial features within 1m. Visual chart of 3m: (1) naked eyesight, not able to discern biggest letters in front of the chart; (2) corrected eyesight, not be able to discern biggest letters at 3m; 0.08 at 2m; 0.1 at 1.5m. Light yellow with dark red area can be seen of left fundus, with arteriovenous ratio as 1:4. Light yellow can be seen of right fundus, without optic papilla seen, black sedimentation seen in the central area. He has a symmetrical forehead wrinkle and nasolabial fold, normal swallowing, normal hearing and free neck movement. He had free limbs movement, normal 4 limbs muscle power and muscle tone, normal 4 limbs tendon reflexes, normal abdominal reflex, negative sucking reflex and a negative palm-jaw reflex bilaterally. There was a negative Hoffmann sign, Rossolimo sign, and Babinski sign bilaterally, normal deep and shallow sensation, normal coordination and a negative meningeal irritation sign.

After the admission he received 3 nerve regeneration treatments (neural stem cells and mesenchymal stem cells) to repair his damaged optic nerves and retinal cells, replace dead nerves and cells, nourish nerves and cells, improve body environment, regulate his immune system and improve blood circulation. This was combined with rehabilitation training.   

After 14 days treatment his vision got better, his left naked eyesight now being able to see fingers at 80cm, to see letters of the second line at 50cm, with left corrected eyesight  being able to see letters of the first line at 3m and to see the fourth line at 1.5m. He now saw objects clearer.


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