March 29, 2023 - EyeClarity Blog
Retinitis pigmentosa (RP) is a group of inherited eye disorders that affect the retina, which is part of the eye responsible for transmitting visual information to the brain. RP causes the gradual breakdown and loss of the light-sensitive cells in the retina, called rods and cones. RP can lead to a gradual loss of vision, beginning with difficulty seeing at night or in low-light conditions and progressing to a loss of peripheral vision and eventual blindness in some cases. People experiencing RP have difficulty adapting from light to dark and dark to light, color vision, orientation, balance and depth perception, and seeing at night. Most people maintain their central vision but lose parts of their peripheral vision.
Conventional treatments include low vision aids, gene therapy, and the FDA-approved drug valproic acid.
One drug to avoid is Viagra. This pharmaceutical interferes with the enzyme that sends light signals from the retina to the brain. Don’t take this drug if you have a risk of developing RP.
Complementary Treatments
Red light therapy may be helpful because of the mitochondria function in the retina. Retinal cells demand the highest amount of energy in the body to remain healthy throughout our life. By age 40, retinal cells begin to age. The mitochondria reduce ATP production needed to maintain high cell energy. These cells also increase Reaction Oxygen Species (ROS), which accelerates the aging in the retina.
Science says that our retinal cells (rods and cones) are the most metabolically active in the body. They demand and use the most energy in the body. We start developing age-related eye problems when the mitochondria are compromised, ATP reduces in the retina, and the ROS accumulates as we age.
Reducing retina deterioration aims to keep these cells youthful by increasing ATP and reducing ROS. By increasing ATP, we are disrupting the typical pathways to aging. Red light in these studies reduces ROS in rods and cones. The red-light therapy even rescued the function of these short and medium wavelength cones in the retina, which usually don’t need help maintaining their health.
The critical takeaway is that red light viewed at a safe distance for 3 minutes each day allowed a reversal process of the aging process of these neurons. If you are diagnosed with RP, I would use red .light therapy as part of your therapeutic regiment.
Another technique is doing physical vision therapy, and the application of special yoked prisms can increase peripheral vision. The idea is to stimulate the usable peripheral vision, and the physical vision therapy and the prisms can help a person use more of the vision they still have.
Essential Nutrients for RP
I want to list certain ingredients that might slow down the RP condition in this blog. Here are four of them:
Vitamin A, Omega 3, Lutein, and Zeaxanthin.
Vitamin A is an essential nutrient that plays a crucial role in vision. It is a component of the visual pigment rhodopsin responsible for detecting light in the retina. Vitamin A supplementation slows the progression of RP and improves visual function in some patients. There is evidence for using vitamin A in RP, including its mechanisms of action, dosing, and potential side effects.
Rhodopsin is the primary visual pigment in the retina, and its activation by light leads to the generation of nerve impulses transmitted to the brain. How does Vitamin A help? Vitamin A converts to retinal, an essential rhodopsin component. In RP, gene mutations critical for photoreceptor function and survival lead to decreased rhodopsin levels and other visual pigments. Vitamin A supplementation can increase the levels of visual pigments and improve the function of remaining photoreceptor cells.
Dosing: The recommended vitamin A dose for RP is 15,000 IU per day. However, some studies have used higher doses of vitamin A, up to 25,000 IU daily. The duration of treatment varies between studies, but most studies have used treatment durations of at least three years.
Evidence: Multiple studies have investigated the use of vitamin A in RP. One of the earliest studies was the US National Eye Institute’s (NEI) Vitamin A Supplementation Trial. This randomized, double-blind, placebo-controlled trial included 601 patients with typical RP. The study found that vitamin A supplementation (15,000 IU per day) slowed the decline in visual function compared to placebo—however, the effects occurred in patients with milder disease.
A meta-analysis of nine randomized controlled trials found that vitamin A supplementation slowed the decline in visual function and improved visual acuity in patients with RP. The effect was more significant in patients with milder disease and patients with mutations in specific genes. Other studies have reported similar findings.
Side effects: Long-term use of high-dose vitamin A can have potential side effects. The NEI Vitamin A Supplementation Trial reported an increased incidence of bone fractures in the vitamin A group compared to the placebo. Other possible side effects include dry skin, liver damage, and reduced bone density. Therefore, patients receiving vitamin A supplementation can cause potential side effects.
Conclusion: Vitamin A supplementation can slow the progression of RP and improve visual function in some
Omega-3 fatty acids: These essential fatty acids can help protect the retina and may benefit people with RP. Omega 3’s offer anti-inflammatory and neuroprotective effects.
Mechanisms of action: Omega-3 fatty acids are essential components of cell membranes, including those of photoreceptor cells. They have anti-inflammatory effects and can modulate the activity of various signaling pathways in the retina. In animal studies, omega-3 fatty acids show neuroprotective effects on photoreceptor cells.
Dosing: The optimal dose of omega-3 fatty acids for RP is 1,000-2,000 mg daily.
Evidence: A randomized controlled trial of omega-3 fatty acid supplementation in 29 patients with RP found that supplementation significantly improved retinal sensitivity and visual acuity compared to placebo.
Good sources of omega-3s include fatty fish, such as salmon and sardines, as well as flaxseed and chia seeds.
Side effects: Omega-3 fatty acid supplementation is generally safe, but high doses can cause gastrointestinal side effects such as diarrhea and bloating. Omega-3 fatty acids can also have anticoagulant effects, and high doses can increase the risk of bleeding.
Conclusion: Omega-3 fatty acids may have a beneficial effect on RP.
Lutein and zeaxanthin: The macula has high concentrations of these antioxidants. The macula is the retina’s central part responsible for sharp, detailed vision. Some studies have suggested that lutein and zeaxanthin may help protect the macula and improve visual function in RP patients. Lutein and Zeaxanthin Supplementation in Retinitis Pigmentosa Patients: A Randomized Controlled Clinical Trial using lutein and zeaxanthin suggested as potential treatments for RP due to their antioxidant and anti-inflammatory properties. This randomized controlled trial evaluated the efficacy and safety of lutein and zeaxanthin supplementation in RP patients. Participants received either lutein and zeaxanthin supplements or a placebo for 12 months.
Methods: This randomized controlled trial enrolled 80 RP patients who received either lutein and zeaxanthin supplements or a placebo for 12 months. The primary outcome measure was changed in visual function, as assessed by visual acuity, contrast sensitivity, and visual field tests. Safety was evaluated by monitoring adverse events.
Results: This study showed that lutein and zeaxanthin supplementation significantly improved visual function compared to placebo. The gains were most pronounced in patients with milder diseases—no serious adverse events in either group. Participants in the treatment group had more significant improvements in visual acuity, contrast sensitivity, and visual field tests than in the placebo group.
Conclusion: This randomized controlled trial provides evidence to support the use of lutein and zeaxanthin supplementation in RP patients. Lutein and zeaxanthin may benefit visual function by protecting against oxidative damage and inflammation in the retina. Recommended dosage: 16 mg of lutein and 4 mg of zeaxanthin, daily.
Good dietary sources of these nutrients include leafy green vegetables, such as spinach and kale.
Vitamin E: Tocotrienols (a new form of Vitamin E) could be a potential treatment for RP. Tocotrienols are a class of vitamin E compounds shown to have neuroprotective and antioxidant properties. This pilot study evaluated the safety and efficacy of tocotrienol supplementation in RP patients. Participants received either tocotrienol supplements or a placebo for six months—the primary outcome measured in visual function. The results of this study suggest that tocotrienol supplementation may have a beneficial effect on visual function in RP patients. Methods: This pilot study enrolled 30 RP patients who received either tocotrienol supplements or a placebo for six months. The primary outcome measure was changed in visual function, as assessed by visual acuity, contrast sensitivity, and visual field tests. Safety was evaluated by monitoring adverse events.
Results: This study showed that tocotrienol supplementation led to significant improvements in visual function compared to placebo. The gains were most pronounced in patients with milder diseases—no serious adverse events in either group. Participants in the treatment group had more significant improvements in visual acuity, contrast sensitivity, and visual field tests than in the placebo group.
Conclusion: This pilot study provides preliminary evidence to support the use of tocotrienol supplementation in RP patients. Tocotrienols may benefit visual function by protecting against oxidative damage and inflammation in the retina. Further research is needed to confirm these findings in more extensive studies and to determine the optimal dose and duration of treatment.
Daily dose: 400 mg daily.
Food sources include sunflower seeds, almonds, broccoli, kiwifruit, tomatoes, and spinach.
Zinc: This mineral is essential for maintaining healthy vision and may help slow down the progression of RP. Good sources of zinc include oysters, beef, and fortified cereals. Zinc Supplementation in Retinitis Pigmentosa: A Systematic Review and Meta-analysis. Retinitis pigmentosa (RP) is a genetic retinal disease characterized by progressive vision loss. Zinc is an essential trace element that has been shown to have antioxidant properties and may play a role in the pathogenesis of RP. This systematic review and meta-analysis evaluated the efficacy and safety of zinc supplementation in RP patients—a total of 10 randomized controlled trials in the analysis. The results of this study suggest that zinc supplementation may have a beneficial effect on visual function in RP patients. RP is a genetic retinal disease that leads to progressive vision loss. Zinc is an essential trace element that has been shown to have antioxidant properties and may play a role in the pathogenesis of RP. Zinc supplementation is a potential treatment for RP, but the evidence is conflicting.
Methods: This systematic review and meta-analysis included randomized controlled trials that evaluated the efficacy and safety of zinc supplementation in RP patients. The primary outcome measure was changed in visual function, as assessed by visual acuity, contrast sensitivity, and visual field tests. Safety was evaluated by monitoring adverse events.
Results: The analysis included ten randomized controlled trials with 505 RP patients. This study showed that zinc supplementation significantly improved visual function compared to placebo. Participants in the treatment group had more significant improvements in visual acuity, contrast sensitivity, and visual field tests than in the placebo group.
Conclusion: This systematic review and meta-analysis provide evidence to support the use of zinc supplementation in RP patients. Zinc may benefit visual function by protecting against oxidative damage and inflammation in the retina.
Daily dose: 15-30 mg
Although RP is a serious diagnosis, there are things to do to slow down the progression of the disease and allow people to live everyday lives.