While nothing currently can be done to stop or reverse the retinal degeneration, there are steps that can be taken to slow the rate of vision loss. UV-blocking sunglasses for outdoors, appropriate dietary intake of fresh fruit and leafy green vegetables, antioxidant vitamin supplements, and regular intake of dietary omega-3 very-long-chain fatty acids are all recommended. One study found that a dietary supplement of lutein increases macular pigment levels in patients with<unk> . Over a long period of time, these elevated levels of pigmentation "could" slow retinal degeneration. Additional interventions that may be needed include surgical correction of retinal detachment and cataracts, low vision services, and counseling to help cope with depression, loss of independence, and anxiety over job loss. Gene therapy Gene therapy is currently not a treatment option, however human clinical trials for both<unk>  and Leber's congenital amaurosis (LCA) have produced somewhat promising results. Clinical trials of gene therapy for patients with LCA began in 2008 at three different sites. In general, these studies found the therapy to be safe, somewhat effective, and promising as a future treatment for similar retinal diseases. In 2011, the first gene therapy treatment for<unk>  was administered. The surgery was performed by Robert MacLaren, Professor of Ophthalmology at the University of Oxford and leader of the Clinical Ophthalmology Research Group at the Nuffield Laboratory of Ophthalmology (NLO). In the study, 2 doses of the AAV.REP1 vector were injected subretinally in 12 patients with<unk> . There study had 2 objectives: * to assess the safety and tolerability of the AAV.REP1 vector * to observe the therapeutic benefit, or slowing of the retinal degeneration, of the gene therapy during the study and at a 24-month post-treatment time point Despite retinal detachment caused by the injection, the study observed initial improved rod and cone function, warranting further study. In 2016, researchers were optimistic that the positive results of 32<unk>  patients treated over four and a half years with gene therapy in four countries could be long-lasting. Preimplantation genetic diagnosis For women who carry a mutation in the<unk>  gene, preimplantation genetic diagnosis can be used during the in-vitro fertilization process to select unaffected embryos to implant. This process call be applied to any monogenic disease. Other potential therapies While<unk>  is an ideal candidate for gene therapy there are other potential therapies that could restore vision after it has been lost later in life. Foremost of these is stem cell therapy. A clinical trial published in 2014 found that a subretinal injection of human embryonic stem cells in patients with age-related macular degeneration and Stargardt disease was safe and improved vision in most patients. Out of 18 patients, vision improved in 10, improved or remained the same in 7, and decreased in 1 patient, while no improvement was seen in the untreated eyes. The study found "no evidence of adverse proliferation, rejection, or serious ocular or systemic safety issues related to the transplanted tissue." A 2015 study used CRISPR/Cas9 to repair mutations in patient-derived induced pluripotent stem cells that cause X-linked retinitis pigmentosa. This study suggests that a patient's own repaired cells could be used for therapy, reducing the risk of immune rejection and ethical issues that come with the use of embryonic stem cells.
Choroideremia
Fungemia
Granulocytosis
Thrombocythemia
Bandemia
Agranulocytosis
Lycopenemia
Asemia