Zainab-Retinitis Pigmentosa-(Pakistan)

Name: Zainab
Sex: Female
Nationality: Pakistani
Age: 27Y
Diagnosis: Retinitis Pigmentosa    
Discharge Date: 2019/03/25

Before treatment:
At the age of 22 the patient had partial visual field loss and visual acuity loss. She went to a local hospital and after a number of examinations she was diagnosed with "retinitis pigmentosa". There is no treatment method. The patient's condition got worse slowly. She has been treated with acupuncture but the effect was not good and 3 years ago her vision decreased rapidly. At present her vision is basically lost under strong light, 3 meters under soft light she can distinguish the outline of the large object but she cannot distinguish the details. At 50cms she can see a finger shaking but cannot distinguish the number of fingers. Bright color can be distinguished.
She has good spirit, diet and sleep, her urination and defecation functions are  normal.

Admission PE:
Bp: 106/79mmHg, Hr: 90/min, breathing rate: 18/min, body temperature: 36.7 degrees. Height 159cm, weight 64Kg. Nutrition status is good with normal physical development. There is no injury or bleeding spots of her skin and mucosa, no blausucht, no throat congestion and her 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, the memory, comprehension and calculation abilitiy examinations were normal. Bilateral pupils were equal and round with a diameter of 3.5mm. The left eye had a poor reaction to light, the right eye can react to light sensitively, she could not distinguish color and can only see some bright colors but with difficulty. At 3 meters distance she can see a blurred human shape, at 50cm she can see finger movement but can not count the fingers. At 15cm she could see fingers but also cannot count them. She can see a light at 2m distance. The eyes fundus examination: right eye: faint yellow, A:V 2:3, there are lots of black osteoid deposit at ambitus area, optic nerve head was pale, blur macula border; left eye: faint yellow or pale color, A:V 1:3, there are lots of black osteoid deposit at ambitus area, optic nerve head was pale, macula area color was pale. The bilateral forehead wrinkle and nasolabial fold are symmetrical, showing teeth was normal, she could make tongue extend out normally and her neck can move freely. The 4 limbs muscle tone were normal, the muscle power was 5 degrees. Abdomen reflex and the 4 limbs tendon reflex were normal, The sucking reflex, bilateral Palm-jaw reflex, Hoffmann sign of both sides, Rossilimo sign and Babinski sign of both sides were all negative. The sensory system was normal, coordinate movement was normal and the meningeal irritation sign was negative.

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

After 14 days treatment she can see a human shape at 3m, see doors at 5m and see things much more clearly. At 1m she can now see fingers open clearly, she could count the number of fingers and she has started to be able to distinguish a human face. Her color distinguishing ability improved also.

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