Ms.Ling-Retinal Degenerative Disease-(Malaysia)

Name: Ms.Ling
Sex: Female
Nationality: Malaysian
Age: 43Y
Diagnosis: Retinal Degenerative Disease  
Discharge Date: 2018/8/20

Before treatment:
The patient had vision decline 15 years ago. She couldn’t see clearly but she did not take any action.10 years ago after a caesarean section, her left eye was blurred so she was seen in the local ophthalmology. After various examinations she was diagnosed with retinitis pigmentosa. Her visual acuity continued to aggravate and 6 years ago her right eye also appeared to have unclear vision. After many visits there was no effective treatment. At present, most of the binocular visual field is missing, only the upper quadrant visual field outside the binocular is preserved, her visual acuity is poor, she can’t see clearly, her color discrimination is poor and she can’t take good care of herself.
Her diet and sleep are basically normal, the defecation and urination functions are normal.

Admission PE:
Bp: 103/61mmHg, Hr: 74/min, breathing rate: 18/min, body temperature: 36.5 degrees. Height 152cm, weight 60Kg. Nutrition status is good with normal physical development. There is no injury or bleeding spots of her skin and mucosa, no blausucht and no throat congestion. 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.

Nervous System Examination:
Patient was alert, had clear speech, her memory, orientation and calculation abilities by examination were normal. The bilateral pupils were equal and round, diameter was 3.0mm, the eyes direct and indirect response to light were sensitive. The eyeballs can move freely and there was no nystagmus. Visual field check: she only kept outer upper quadrant visual field, with blurred vision, the others were lost completely. Her color distinguishing ability was decreased also. Only when she was in a bright environment could she distinguish the bright colors. The eyes fundus examination: the eyes fundus was faint yellow, pale optic nerve head, A:V=1:3, with osteoid sediment. Left eye macula area is bigger than right side, with unclear border. The bilateral forehead wrinkle and nasolabial fold are symmetrical, showing teeth was normal and she could make her tongue extend out normally. Her neck could move freely, the 4 limbs muscle tone was normal, the muscle power of 4 limbs was 5 degrees. The abdomen reflex was normal, the bilateral biceps reflex and radial periosteal reflex could not be induced, the triceps reflex was normal, the patellar tendon reflex of both sides was normal, the ankle clonus of both sides could not be induced and the palm-jaw reflex was negative. The bilateral Hoffmann sign, the arm Rossilimo sign and the pathological reflex of the legs were all negative. Her sensory examination was normal and the coordinate movement was normal.

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

Post-treatment:
After 14 days treatment her eyesight on both sides had some positive change. The central eye vision was much more sensitive to light, the outside can see things much more clearly than before. She could now distinguish fingers at 70cm and she could see the shape of things within 2m. She could see bright colours such as red, blue and yellow. The eyes fundus examination showed that the  blood supply of both eye fundus were improved.

 

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