Muhammad Ahmed Saeed-Retinitis Pigmentosa-(Pakistan)

Name: Muhammad Ahmed Saeed
Sex: Male
Nationality: Pakistani
Age: 31Y
Diagnosis: Retinitis Pigmentosa 
Discharge Date: 2019/03/25

Before treatment:
The patient did not notice a slow decline in visual acuity 16 years ago, he did not care. 4 years ago there was a sharp decline in vision, photophobia. The family took him to the hospital for treatment and he was diagnosed with "retinal pigmentosa" 2 years ago but he had no special treatment. At present, the patient's eyes can distinguish part of the contour of the human face at 2 meters. With about 1m as the node, the outward visual acuity gradually decreases, the inward vision is gradually blurred and some colors can be distinguished. The patient came to our hospital for further treatment. He has a good spirit since the onset of the disease, eating and sleeping are basically normal with normal bowel movements.

Admission PE:
Bp: 120/80mmHg, Hr: 92/min, breathing rate: 19/min, body temperature: 37 degrees. Height 172cm, weight 102.5Kg. Nutrition status is good with normal physical development. There is no injury or bleeding spots of his skin and mucosa, no blausucht, no throat congestion and his tonsils do not have swelling. Chest development was normal, the respiratory sounds in both lungs were clear and there were no dry or moist rales. The heart beat is powerful with regular cardiac rhythm and no obvious murmur in the valves. The abdomen was flat and soft with no masses or tenderness. The liver and spleen were normal and there is no edema of the legs.

Nervous System Examination:
Patient was alert, had clear speech, his memory, comprehension and calculation ability examinations were normal. Bilateral pupils were equal and round, diameter 4mm. The right eye reaction to light was not good occasionally, left eye can react to light slowly at first. He could distinguish part of a human face at 2m distance. Eyesight chart examination: eyesight 0.1 at 1.5m; eyesight 0.25 at 40-50cm. The eyes fundus examination: right eye: faint yellow, A:V 1:3, there are black osteoid deposit at ambitus area, optic nerve head was pale,; left eye: faint yellow color, A:V 1:3, there are lots of black osteoid deposit below bitamporal area, cover the macula area, border was unclear, optic nerve head was pale. His eyeballs can move freely. The bilateral forehead wrinkle and nasolabial fold are symmetrical, showing teeth was normal, he could make his tongue extend out normally and his neck can move freely. The 4 limbs muscle tone were normal, muscle power was 5 degrees, abdomen reflex was normal and the 4 limbs tendon reflex were normal. The sucking reflex, bilateral Palm-jaw reflex, Hoffmann sign of both sides, Rossilimo sign and the Babinski sign of both sides were all negative. The sensory system was normal, coordinate movement was normal, the meningeal irritation sign was negative.

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

After 14 days treatment he was less lucifugous, his vision function was better,
he can see a human face at 3m, see more colors and shapes of objects and his vision was now 0.15 at 1.5m. His eyes fundus examination: left eye: light red color, the black osteoid deposit at ambitus area reduced around 30%, Right eye: dark red color, the black osteoid deposit at ambitus area reduced.

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