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Third (Final) Contributions

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Assignment 3

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[3] [4] [5]

Goals

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What I intend to work on to finalize the Retinitis Pigmentosa article

1. Formalize a final outline from the preliminary outline draft
  • 5/10/15
2. Add any remaining subsections from the final outline
  • Epidemiology added 5/11/15
3. Edit links, grammar, citations, etc.
  • Review peer review comments and make final revisions
4. Images!! - I am having trouble with image copyrights and am hoping to resolve this soon
  • Symptoms image added 4/28/15 - Changed to a new image 5/11/15
  • Rods and Cones Scanning EM image added 4/28/15
  • Argus II Image added 5/11/15
  • Visual Field Image added 5/11/15
5. Completely edit entire article (grammar, links, citations, etc)
  • Completed 5/11/15
5. Include diffs for final contributions
  • 5/11/15

Final Outline

I. Introduction : Classification
A. Degeneration of the retina
1. Rod photoreceptor cells
B. Inherited (Genetic)
C. Progressive
D. Symptoms (brief)
II. Symptoms
A. Night blindness/ peripheral vision affects
B. Progression
1. Peripheral vision decreases / tunnel vision
2. Visual acuity
3. Symmetrical
C. Accompanying Symptoms
1. Photophobia and Photopsia
2. Ophthalamic Triad
D. List Non-syndromic RP symptoms
III. Genetics
A. Inherited gene mutation
1. Autosomal recessive, autosomal dominant, X-linked, Mitochondrial
2. Rhosopsin/RHO
a. 1989 discovery
b. protein misfolding or Pro23His codon mutation
c. many mutation of RHO present in RP
3. Autosomal dominant pre-mRNA splicing factors
i. PRPF3, PRPF8, PRPF31, PAP1
4. X-linked
a. RPGR
5. OMIM chart
IV. Pathophysiology
A. Mechanism of rod degeneration
1. Class I and Class II Types
B. Animal Studies
1. RPE Effects
2. cGMP phosphodiesterase
C. Image
V. Associated Conditions
A. Non-Syndromic
B. Syndromic
C. Secondary
V. Diagnosis
A. Presentation of early symptoms and typical disease progression
B. Visual Field Tests / Visual Acuity Tests
B. Full-Field Electroretinogram (ERG) testing
1. Mechanism
C. Family History / DNA Testing
1. List of genes for testing
2. Inheritance Patterns
3. Genetic Counseling
VI. Treatment
A. Vitamins/Supplements
1. Vitamin A, DHA, Lutein
B. Retinal Prosthetics
1. Types and Mechanisms
C. Stem cells, Retinal progenitor cells, retinal pigment epithelium implantation
D. Gene Therapy
VII. Prognosis / Outlook / Outcome
A. No cure
B. Treatments still in trial/research/study stages
C. Varying levels of severity/progression influence prognosis
D. Children in presymptomatic stages benefit from genetic counseling
VIII. Current Research
A. 2006 - 20014
IX Notable Cases
List
X. Epidemiology / Social Implications

Second Contributions

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Assignment 2
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[7] [8] [9] [10] [11][12]

Goals

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What I intend to work on this week is

1. Add new information and paragraphs to Pathophysiology subsections
  • completed 4/16/15
2. Diagnosis subsection
  • Additional paragraphs/information, original article missing many citations, possibly omit unfitting information
  • completed 4/16/15
3. Work on additional subsections (Treatment, Prognosis, Prevention/Screening)
  • Treatment - added 4/21/15
  • Prognosis - added 4/22/15
4. Reevaluate my preliminary outline
  • Changes/Additions
5. Grammar edits throughout entire RP article
  • Including correct formatting and citations for medical articles
6. Images
7. Add diffs for Assignment 1 and 2

Diagnosis Edits

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An accurate diagnosis of retinitis pigmentosa relies on the documentation of the progressive loss photoreceptor cell function, confirmed by a combination of visual field and visual acuity tests, fundus and optical coherence imagery, and electroretinography (ERG),[1]

Visual field and acuity tests measure and compare the size of the patient's field of vision and the clarity of their visual perception with the standard visual measurements associated with healthy 20/20 vision. Clinical diagnostic features indicative of Retinitis Pigmentosa include a substantially small and progressively decreasing visual area in the visual field test, and compromised levels of clarity measured during the visual acuity test.[2]Additionally, optical tomography such as fundus and retinal (optical coherence) imagery provide further diagnostic tools when determining an RP diagnosis. Photographing the back of the dilated eye allows the confirmation of bone spicule accumulation in the fundus, which presents during the later stages of RP retinal degeneration. Combined with cross-sectional imagery of optical coherence tomography, which provides clues into photoreceptor thickness, retinal layer morphology, and retinal pigment epithelium physiology, fundus imagery can help determine the state of RP progression.[3]

While visual field and acuity test results combined with retinal imagery support the diagnosis of Retinitis Pigmentosa, additional testing is neccesary to confirm other pathological features of this disease. Electroretinography (ERG) confirms the RP diagnosis by evaluating functional aspects associated with photoreceptor degeneration, and can detect physiological abnormalities before the initial manifestation of symptoms. An electrode lens is applied to the eye as photoreceptor response to varying degrees of quick light pulses is measured. Patients exhibiting the Retinitis Pigmentosa phenotype would show decreased or delayed electrical response in the rod photoreceptors, as well as possibly compromised cone photoreceptor cell response. [4]

The patient's family history is also considered when determining a diagnosis due to the genetic mode of inheritance of Retinitis Pigmentosa. At least 35 different genes or loci are known to cause "nonsyndromic RP" (RP that is not the result of another disease or part of a wider syndrome). Indications of the RP mutation type can be determine through DNA testing, which is available on a clinical basis for:

  • RLBP1 (autosomal recessive, Bothnia type RP)
  • RP1 (autosomal dominant, RP1)
  • RHO (autosomal dominant, RP4)
  • RDS (autosomal dominant, RP7)
  • PRPF8 (autosomal dominant, RP13)
  • PRPF3 (autosomal dominant, RP18)
  • CRB1 (autosomal recessive, RP12)
  • ABCA4 (autosomal recessive, RP19)
  • RPE65 (autosomal recessive, RP20)[5]

For all other genes (e.g. DHDDS), molecular genetic testing is available on a research basis only.

NOTE : I MAY OMIT WHAT IS BELOW FROM DIAGNOSIS - It seems to belong more in the Causes subsection

RP can be inherited in an autosomal dominant, autosomal recessive, or X-linked manner. X-linked RP can be either recessive, affecting primarily only males, or dominant, affecting both males and females, although males are usually more mildly affected. Some digenic (controlled by two genes) and mitochondrial forms have also been described.

Genetic counseling depends on an accurate diagnosis, determination of the mode of inheritance in each family, and results of molecular genetic testing.

Treatment Edits

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There is no cure for retinitis pigmentosa; however, the efficacy and safety of various prospective treatments are currently being evaluated. The efficiency of various supplements, such as Vitamin A and Lutein, in delaying disease progression remains an unresolved, yet prospective treatment option. Clinical trials investigating optic prosthetic devices, gene therapy mechanisms, and retinal sheet transplantations are active areas of study in the partial restoration of vision in Retinitis Pigmentosa patients [6]

Studies have demonstrated the delay of rod photoreceptor degeneration by the daily intake of 15000 IU (equivalent to 4.5 mg) of vitamin A palmitate; thus, stalling disease progression in some patients.[7] Recent investigations have shown that proper vitamin A supplementation can postpone blindness by up to 10 years (by reducing the 10% loss pa to 8.3% pa) in some patients in certain stages of the disease.[8]

The Argus retinal prosthesis became the first approved treatment for the disease in February 2011, and is currently available in Germany, France, Italy, and UK.[9] Interim results on 30 patients long term trials were published in 2012.[10] The Argus II retinal implant has also received market approval in the USA.[11] The device may help adults with RP who have lost the ability to perceive shapes and movement to be more mobile and to perform day-to-day activities. In June 2013, twelve hospitals in the USA announced to soon accept consultation for patients with RP in preparation for the launch of Argus II later that year.[12] The Alpha-IMS is a subretinal implant involving the surgical implantation of a small image-recording chip beneath the optic fovea. Measures of visual improvements from Alpha-IMS studies require the demonstration of the device's safety before proceeding with clinical trials and granting market approval. [13]

The goal of gene therapy studies is to virally supplement retinal cells expressing mutant genes associated with the Retinitis Pigmentosa phenotype with healthy forms of the gene; thus, allowing the repair and proper functioning of retinal photoreceptor cells in response to the instructions associated with the inserted healthy gene. Clinical trials investigating the insertion of the healthy RPE65 gene in retinas expressing the LCA2 Retinitis Pigmentosa phenotype measured modest improvements in vision; however, the degradation of retinal photoreceptors continued at the disease-related rate.[14] Likely, gene therapy may preserve remaining healthy retinal cells while failing to repair the earlier accumulation of damage in already diseased photoreceptor cells. [15] Response to gene therapy would theoretically benefit young patients exhibiting the shortest progression of photoreceptor decline; thus, correlating to a higher possibility of cell rescue via the healthy inserted gene. [16]


NOTE : Include information about transplants and other supplements (lutein, DHA)

Prognosis - New section

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The progressive nature of and lack of a definitive cure for Retinitis Pigmentosa contribute to the inevitably slim prognosis of this disease. While complete blindness is rare [17], the patient's visual acuity and visual field will continue to decline as initial rod photoreceptor and later cone photoreceptor degradation proceeds. Possible treatments remain in the research and clinical trial stages; however, the active studies concerning visual restoration in Retinitis Pigmentosa prove promising for the future.

Indications that children carrying the disease genotype benefit from presymptomatic counseling in order to prepare for the physical and social implications associated with progressive vision loss. While the physological prognosis can be slightly alleviated with active counseling[18] the physical implications and progression of the disease depend largely on the age of initial symptom manifestation and the rate of photoreceptor degradation, rather than access to prospective treatments. Corrective visual aides and personalized vision therapy provided by Low Vision Specialists may help patients correct slight disturbances in visual acuity and optimize their remaining visual field. Support groups, vision insurance, and lifestyle therapy are additional useful tools for those managing progressive visual decline.[19]

First Contributions

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Assignment 1
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[14] [15] [16] [17] [18][19]


Goals

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What I intend to do this week is

1. Change any sentences I think may be plagiarized
  • Intro paragraph - first sentence
  • Chunks of the Symptoms section
2. Locate and resolve any uncited material
  • The Symptoms section was completely uncited
3. Reorganize the Wikipedia article according to my preliminary outlines
  • I will continue to reorganize as I add more sections in order to preserve the article's integrity while it is being edited, and so that no empty sections appear
4. Add some paragraphs from my sand box to the article
  • Intro paragraph was added Mon. 3/16/15
  • Symptoms paragraph was added Mon. 3/16/15
  • Causes paragraph added Tues. 3/17/15
  • Treatment Paragraph in sandbox (will edit more before adding) 3/9/15
  • Pathophysiology Section beginning edits in sandbox 3/17/15

Intro Edits

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Retinitis pigmentosa (RP) is an inherited, degenerative eye disease that causes severe vision impairment [20] due to the progressive degeneration of the rod photoreceptor cells in the retina. This form of retinal dystrophy manifests initial symptoms independent of age; thus, RP diagnosis occurs anywhere from early infancy to late adulthood.[21] Patients in the early stages of RP first notice compromised peripheral and dim light vision due to the decline of the rod photoreceptors [22] The progressive rod degeneration is later followed by abnormalities in the adjacent retinal pigment epithelium (RPE) and the deterioration of cone photoreceptor cells. As peripheral vision becomes increasingly compromised, patients experience progressive "tunnel vision" and eventual blindness.[23] Affected individuals may additionally experience defective light-dark adaptations, nyctalopia (night blindness), and the accumulation of bone spicules in the fundus fundus (eye).

Carolynslu (talk) 18:57, 16 March 2015 (UTC)

Symptoms Edits

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Version 1

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Retinitis Pigmentosa is characterized by decreased low-light vision (nyctalopia) and the loss of the mid-peripheral visual field during the initial stages of retinal degeneration. Cite error: A <ref> tag is missing the closing </ref> (see the help page). Visual field loss progresses relatively quickly to the far periphery, eventually extending into the central visual field as tunnel vision increases. Visual acuity and color vision may become compromised as rod photoreceptor cell degeneration is later accompanied by abnormalities in the cone photoreceptor cells, which are responsible for color vision, visual acuity, and sight in the central visual field.[24] The progression of disease symptoms occurs in a symmetrical manner, with both the left and right eyes experiencing symptoms at a similar rate. [25]

A variety of atypical symptoms also characterize Retinitis Pigmentosa, accompanying the progressive affects of the initial rod photoreceptor degeneration and later cone photoreceptor decline. Phenomena such as photophobia, which describes the event in which light is perceived as an intense glare, and photopsia, the presence of blinking or shimmering lights within the visual field, often manifest during the later stages of RP. Findings related to RP have often been characterized in the fundus (eye) of the eye as the Ophthalamic triad. This includes the development of bone spicules in retinal pigment epithelium (RPE), a waxy appearance of the optic nerve, and the attentuation of blood vessels in the retina. [26]

Patients typically experience one or more of the following symptoms:

  • Night blindness or nyctalopia;
  • Tunnel vision (due to loss of peripheral vision);
  • Latticework vision;
  • Photopsia (blinking/shimmering lights);
  • Photophobia (Aversion to glare);
  • Development of bone spicules in the fundus;
  • Slow adjustment from dark to light environments and vice versa;
  • Blurring of vision;
  • Poor color separation;
  • Loss of central vision;
  • Eventual blindness

Version 2

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The initial retinal degenerative symptoms of Retinitis Pigmentosa are characterized by decreased night vision (nyctalopia) and the loss of the mid-peripheral visual field. [27]. The rod photoreceptor cells, which are responsible for low-light vision and are orientated in the retinal periphery, are the retinal processes affected first during non-syndromic forms of this disease. [28] Visual decline progresses relatively quickly to the far peripheral field, eventually extending into the central visual field as tunnel vision increases. Visual acuity and color vision can become compromised due to accompanying abnormalities in the cone photoreceptor cells, which are responsible for color vision, visual acuity, and sight in the central visual field.[29] The progression of disease symptoms occurs in a symmetrical manner, with both the left and right eyes experiencing symptoms at a similar rate. [30]

A variety of indirect symptoms characterize Retinitis Pigmentosa along with the direct affects of the initial rod photoreceptor degeneration and later cone photoreceptor decline. Phenomena such as photophobia, which describes the event in which light is perceived as an intense glare, and photopsia, the presence of blinking or shimmering lights within the visual field, often manifest during the later stages of RP. Findings related to RP have often been characterized in the fundus (eye) of the eye as the Ophthalamic triad. This includes the development of a mottled appearance of the retinal pigment epithelium (RPE) caused by bone spicule formation, a waxy appearance of the optic nerve, and the attentuation of blood vessels in the retina. [31]

Non-syndromic RP usually presents a variety of the following symptoms:

  • Night blindness or nyctalopia;
  • Tunnel vision (due to loss of peripheral vision);
  • Latticework vision;
  • Photopsia (blinking/shimmering lights);
  • Photophobia (Aversion to glare);
  • Development of bone spicules in the fundus;
  • Slow adjustment from dark to light environments and vice versa;
  • Blurring of vision;
  • Poor color separation;
  • Loss of central vision;
  • Eventual blindness

Carolynslu (talk) 18:59, 16 March 2015 (UTC)

Genetics

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Retinitis pigmentosa (RP) is one of the most common forms of inherited retinal degeneration.[32] There are multiple genes that, when mutated, can cause the retinitis pigmentosa phenotype.[33] Inheritance patterns of RP have been identified as autosomal dominant, autosomal recessive, X-linked, and maternally (mitochondrially) acquired , and are dependent on the specific RP gene mutations present in the parental generation. [34]. In 1989, a mutation of the gene for rhodopsin, a pigment that plays an essential part in the visual transduction cascade enabling vision in low-light conditions, was identified. Since then, more than 100 mutations have been found in this gene, accounting for 15% of all types of retinal degeneration. Most of those mutations are missense mutations and inherited mostly in a dominant manner.

Types include:

OMIM Gene Type
180100 RP1 Retinitis pigmentosa-1
312600 RP2 Retinitis pigmentosa-2
300029 RPGR Retinitis pigmentosa-3
608133 PRPH2 Retinitis pigmentosa-7
180104 RP9 Retinitis pigmentosa-9
180105 IMPDH1 Retinitis pigmentosa-10
600138 PRPF31 Retinitis pigmentosa-11
600105 CRB1 Retinitis pigmentosa-12, autosomal recessive
600059 PRPF8 Retinitis pigmentosa-13
600132 TULP1 Retinitis pigmentosa-14
600852 CA4 Retinitis pigmentosa-17
601414 HPRPF3 Retinitis pigmentosa-18
601718 ABCA4 Retinitis pigmentosa-19
602772 EYS Retinitis pigmentosa-25
608380 CERKL Retinitis pigmentosa-26
607921 FSCN2 Retinitis pigmentosa-30
609923 TOPORS Retinitis pigmentosa-31
610359 SNRNP200 Retinitis pigmentosa 33
610282 SEMA4A Retinitis pigmentosa-35
610599 PRCD Retinitis pigmentosa-36
611131 NR2E3 Retinitis pigmentosa-37
268000 MERTK Retinitis pigmentosa-38
268000 USH2A Retinitis pigmentosa-39
612095 PROM1 Retinitis pigmentosa-41
612943 KLHL7 Retinitis pigmentosa-42
268000 CNGB1 Retinitis pigmentosa-45
613194 BEST1 Retinitis pigmentosa-50
613464 TTC8 Retinitis pigmentosa 51
613428 C2orf71 Retinitis pigmentosa 54
613575 ARL6 Retinitis pigmentosa 55
613617 ZNF513 Retinitis pigmentosa 58
613861 DHDDS Retinitis pigmentosa 59
613194 BEST1 Retinitis pigmentosa, concentric
608133 PRPH2 Retinitis pigmentosa, digenic
613341 LRAT Retinitis pigmentosa, juvenile
268000 SPATA7 Retinitis pigmentosa, juvenile, autosomal recessive
268000 CRX Retinitis pigmentosa, late-onset dominant
300455 RPGR Retinitis pigmentosa, X-linked, and sinorespiratory infections, with or without deafness

The rhodopsin gene encodes a principal protein of photoreceptor outer segments. Studies show that mutations in this gene are responsible for approximately 25% of autosomal dominant forms of RP.[32][35]

Mutations in four pre-mRNA splicing factors are known to cause autosomal dominant retinitis pigmentosa. These are PRPF3 (human PRPF3 is HPRPF3; also PRP3), PRPF8, PRPF31 and PAP1. These factors are ubiquitously expressed and it is proposed that defects in a ubiquitous factor (a protein expressed everywhere) should only cause disease in the retina because the retinal photoreceptor cells have a far greater requirement for protein processing (rhodopsin) than any other cell type.[36]

Up to 150 mutations have been reported to date in the opsin gene associated with the RP since the Pro23His mutation in the intradiscal domain of the protein was first reported in 1990. These mutations are found throughout the opsin gene and are distributed along the three domains of the protein (the intradiscal, transmembrane, and cytoplasmic domains). One of the main biochemical causes of RP in the case of rhodopsin mutations is protein misfolding, and molecular chaperones have also been involved in RP.[37] It was found that the mutation of codon 23 in the rhodopsin gene, in which proline is changed to histidine, accounts for the largest fraction of rhodopsin mutations in the United States. Several other studies have reported other mutations which also correlate with the disease. These mutations include Thr58Arg, Pro347Leu, Pro347Ser, as well as deletion of Ile-255.[35][38][39][40][41] In 2000, a rare mutation in codon 23 was reported causing autosomal dominant retinitis pigmentosa, in which proline changed to alanine. However, this study showed that the retinal dystrophy associated with this mutation was characteristically mild in presentation and course. Furthermore, there was greater preservation in electroretinography amplitudes than the more prevalent Pro23His mutation.[42]

Autosomal recessive inheritance patterns of RP have been identified in at least 45 genes. [43]. This means that two unaffected individuals who are carriers of the same RP-inducing gene mutation in diallelic form can produce offspring with the RP phenotype. A mutation on the USH2A gene is known to cause 10-15% of a syndromic form of RP known as Usher's Syndrome when inherited in an autosomal recessive fashion. [44]

The somatic, or X-linked inheritance patterns of RP are currently identified with the mutations of six genes, the most common occurring at specific loci in the RPGR and RP2 genes. [45]

Carolynslu (talk) 15:23, 17 March 2015 (UTC)

Pathophysiology Edits

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A variety of retinal molecular pathway defects have been matched to multiple known RP gene mutations. Mutations in the rhodopsin gene, which is responsible for the majority of autosomal-dominantly inherited RP cases, disrupts the rod-opsin protein essential for translating light into decipherable electrical signals within the phototransduction cascade of the central nervous system. Defects in the activity of this G-protein-coupled receptor are classified into distinct classes that depend on the specific folding abnormality and the resulting molecular pathway defects. The Class 1 mutant protein's activity is compromised as specific point mutations in the protein-coding amino acid sequence affect the pigment protein's transportation into the outer segment of the eye, where the phototransduction cascade is localized. Additionally, the misfolding of Class II rhodopsin gene mutations disrupts the protein's conjunction with 11-cis-retinal to induce proper chromophore formation. Additional mutants in this pigment-encoding gene affect protein stability, disrupt mRNA integrity post-translationally, and affect the activation rates of transducin and opsin optical proteins. [46]


Animal models suggest that the retinal pigment epithelium fails to phagocytose the outer rod segment discs that have been shed, leading to an accumulation of outer rod segment debris. In mice that are homozygous recessive for retinal degeneration mutation, rod photoreceptors stop developing and undergo degeneration before cellular maturation completes. A defect in cGMP-phosphodiesterase has also been documented; this leads to toxic levels of cGMP.

Working Bibliography

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See RP Talk Page[47]

Carolynslu (talk) 02:58, 10 March 2015 (UTC)

Writing Practice

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Treatment

While previous research has indicated the decreased progression of Retinitis Pigmentosa associated with a modified vitamin A- and Omega-rich diet, no effective cure has been established to completely restore the sight of victims of this degenerative retinal disease. [48] Current trials are studying the effectiveness of novel and innovative technologies that could possibly be applied to Retinitis Pigmentosa treatment, such as the use of gene therapy or prosthetic implants. Gene therapy trials introduced functional RPE65 in the retinal cells of disease candidates, and showed improved vision after various trials. The RPE65 gene encodes for the retinal pigment epithelium, which is also affected in Retinitis Pigmentosa, so any vision improvement was likely due to the restoration of effective nourishment to conflicted photoreceptor cells. The photoreceptor cells continued to display cell death and disfunction despite any vision improvements, most likely initiated by an irreversible cascade of degeneration and cell death. Thus, gene therapy studies confirm the safety and alteration of the disease's steady progression, but methods to revitalize damaged photoreceptor cells remain undiscovered. [49] Efforts are also being focused on the development of optical prosthetics, such as the Argus II. While studies have shown the increased detection of movement and shape perception due to enhanced light and dark recognition, complete visual restoration remains undocumented for these prosthetic devices. [50]

Preliminary Outline

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Retinitis Pigmentosa Wikipedia Article

Preliminary Outline

I. Introduction : Classification
A. Degeneration of the retina
1. Rod photoreceptor cells
B. Inherited (Genetic)
C. Progressive
II. Symptoms
A. Varying range of severity
1. Mild : Night blindness/nyctalopia
2. Severe : Blindness
B. Manifestion
1. Initial stages correlate to characteristic rod degeneration
2. Signs : compromised peripheral and night vision
C. Progression
1. Tunnel vision / decreasing radius of central visual field / loss of visual periphery
2. Fundus formation
3. Eventually affects Cone photoreceptors
a. loss of color vision
b. loss of central vision
D. Additional symptoms
a. headaches
b. light flashes
III. Causes
A. Inherited gene mutation
1. Autosomal recessive
2. Autosomal dominant mutations
a. rhodopsin / RHO
i. protein misfolding
ii. Pro23His codon
b. pre-mRNA splicing factors
i. PRPF3, PRPF8, PRPF31, PAP1
3. X-linked
a. RPGR
4. Digenic mutation inheritance
5. Mitochondrial form
IV. Pathophysiology
A. Mechanism of rod degeneration
1. Physiological affects on the retina and vision
B. Mechanism of progression from rod to cone photoreceptors
2. Further physiological affects on the retina and vision
V. Diagnosis
A. Presentation of early symptoms and typical disease progression
B. Full-Field Electroretinogram (ERG) testing
1. Mechanism
2. Measurements
a. a- and b- wave times and amplitudes
C. "RP triad"
1. attenuation of retinal arteries
2. waxy disc formation
3. pigment changes of the fundus
a. hypopigmentation
b. hyperpigmentation due to bone-spicules
D. Additional Indicative signs
1. Retinal pigment epithelium atrophy
2. macular lesions and cataracts
3.. visual refractive errors such as myopia and astigmatism
E. Additional Tests
1. Dark adaptometry
2. Peripheral vision measurements
3. Genetic testing for RP mutations
VI. Treatment / Management
A. Vitamins/Supplements
1. Vitamin A
2. DHA
3. Lutein
B. Retinal Prosthetics
1. Types and Mechanisms
C. Stem cells, Retinal progenitor cells, retinal pigment epithelium implantation
D. Potential treatments of the future
VII. Prognosis / Outlook / Outcome
A. No cure
B. Treatments still in trial/research/study stages
C. Varying levels of severity/progression influence prognosis
VIII. Prevention / Screening
A. Genetic screening
B. Healthy preventative practices may slow inevitable manifestation/progression
1. Diet
2. Behavior (avoidance of direct contact with bright light)
IX History
X. Epidemiology / Social Implications
A. Disease Distribution
1. Prevalence in society
2. Age groups affected
3. No discriminated for a particular geographic region or ethnicity
B. Confinement in particular family lines
C. Syndromic RP - related syndromes
1. Usher Syndrome
2. Bardet Biedl Syndrome
3. Additional metabolic, neurological, and renal diseases coupled to syndromic RP


Carolynslu (talk) 17:35, 4 March 2015 (UTC)

Initial Article Assessment

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Retinitis Pigmentosa

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Evaluation of Good Article Criteria

1. Well Written

  • The article seems a bit disorganized and would benefit from some sort of outline or framework
  • Slightly wordy
  • Slightly repetitive
  • The introduction seems to jump from one topic to the next
  • Format is slightly inconsistent
  • Symptoms in bullet-list form with semi-colon
  • Associated conditions in numbered paragraph form

2. Verifiable

  • Missing citations
  • "Associated Conditions" section contains no references or sources
  • Includes many links to clarify definitions of biological and medical origin

3. Broad in Coverage

  • Includes a variety of aspects of Retinitis pigmentosa
  • Progress, Genes, symptoms, variability,

4. Neutral

  • The article does not seem to be swayed by opinion/bias

5. Stable

  • No frequent changes noted so far

6. Illustrated by Images

  • Currently just two images
  • Eye/retina
  • Tunnel Vision
  • Images to Include

Talk Page Discussions

  • Talk Page contains a "To Do" List
  • Expand infobox
  • Possible new sections/expansion of existing sections:
  • Classification, Causes, Pathophysiology, Prognosis, Prevention, Epidemiology, History, Social impact, Notable cases (if any), Inline references
  • Add colored images
  • Explain term "retinitis", which implies inflammation
  • Update diagnosis
  • This section should be updated frequently, as the determining the genes and inheritance patterns is a dynamic research area
  • Wording
  • Comprehensibility for the general public, while still adhering to the medical article format
  • Rewrite introduction
  • Word Choice
  • "suffering"
  • rod-cone dystrophy

References and Resources

  1. Farrell, Donald F. “Unilateral Retinitis Pigmentosa and Cone-Rod Dystrophy.” Clinical ophthalmology (Auckland, N.Z.) 3 (2009): 263–270. Print. [20]
  2. Stingl, Katarina et al. “Artificial Vision with Wirelessly Powered Subretinal Electronic Implant Alpha-IMS.” Proceedings of the Royal Society B: Biological Sciences 280.1757 (2013): 20130077. PMC. Web. 12 Feb. 2015. [21]
  3. Telander, David G., MD PhD. "Retinitis Pigmentosa." Medscape. WebMD, 20 Feb. 2014. Web. 10 Feb. 2015. [22]
  4. "Learning About Retinitis Pigmentosa." National Human Genome Research Institute. National Institute of Health, 27 Dec. 2013. Web. 10 Feb. 2015. [23]

Images

  • I would like to include an image similar to this page [24]
  • A picture depicting treatments, such as prosthetic devices[25], stem cell therapy, etc

Talk Page Comments

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[[26]] [[27]]

This is my Practice Article

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Purpose

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The purpose of this article is for sandbox practice on Wikipedia. I will eventually be editing the Retinitis Pigmentosa page on Wikipedia. I will be adhering to the assignment calendar specific to this course page.

File:Http://www.news-medical.net/image.axd?picture=2013/1/RP3.jpg
Still figuring out how to add pictures[citation needed]

Retinitis Pigmentosa

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What

  • Retinitis Pigmentosa generally affects the rod photoreceptor cells of the optical retina, and manifests with symptoms such as decreased night vision and the progressive development of tunnel vision. [51].

How

  • Many different gene mutations have been correlated with the development of this degenerative eye disease. Notably, genes RHO, RP2, RPGR, and USH2A are known to produce autosomal dominant, autosomal recessive, and X-linked inheritance patterns of Retinitis Pigmentosa. [52]

Misconceptions

  • Retinitis Pigmentosa is not the same as Macular Degeneration. In fact, the two diseases present in opposite ways, with the cone photoreceptor cells affected first during Macular Degeneration.[citation needed]
  • RP is not caused by external influences, such as optical injury, damage, or infection. [53] The disease is inherited as a gene mutation. (See How - I want to redirect to the "How section of my practice sandbox)


Carolynslu (talk) 18:29, 4 February 2015 (UTC)


References:

  1. ^ http://www.kellogg.umich.edu/patientcare/downloads/Understand-Retinitis-Pigmentosa.pdf
  2. ^ http://www.ncbi.nlm.nih.gov/books/NBK1417/
  3. ^ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3131734/
  4. ^ http://cdn.intechopen.com/pdfs-wm/17267.pdf
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