Retinal Cells Rewire to Preserve Vision in Retinitis Pigmentosa

Retinitis Pigmentosa is a progressive eye disease that has long been associated with gradual vision loss and limited treatment options. Affecting about one in every 4,000 people, Retinitis Pigmentosa (RP) is marked by the degeneration of the retina’s photoreceptor cells—first the rods, which are responsible for night vision, and then the cones, which enable us to see in daylight and color. While the genetic complexity and slow progression of RP have posed challenges for patients and researchers alike, recent discoveries are offering new hope. Exciting new research reveals that the retina may have an unexpected ability to adapt: certain retinal cells can rewire themselves in response to degeneration, potentially helping to preserve vision even as the disease advances.

Progressive Vision Loss and Oxidative Damage

The condition leads to progressive vision loss. Rod cells use a lot of oxygen, and after their death, the amount of oxygen in the retina increases. Additional oxygen causes oxidative damage to cone cells. ¹ This is a self-reinforcing cycle.

Genetics Overview

Retinitis pigmentosa includes a group of inherited disorders. This includes Leber’s Disease, in which the rods and cones that make up the photoreceptor cells in the retina are dysfunctional due to genetic mutations. There are over 100 genetic variations related to Retinitis Pigmentosa. However, about half of retinitis pigmentosa cases have no apparent family history.

Signs and Symptoms

The typical symptoms include decreased night vision and reduced peripheral vision. Marked loss of vision typically develops over many years. The diagnosis is made through a complete and thorough eye examination and includes a special test called an electroretinogram (ERG).

• Night blindness is the inability to see in low light conditions.
• Color vision deteriorates when the patient is less able to discriminate color details.
• Peripheral vision deteriorates giving the effect of tunnel vision.
• Detailed vision deterioration is also an early symptom.

Latest Research Including Retinal Cells Rewired

Scientists at the Jules Stein Eye Institute at the David Geffen School of Medicine at UCLA have discovered that certain retinal cells can rewire themselves when vision begins to deteriorate in retinitis pigmentosa. ²

Using mouse models of retinitis pigmentosa, new research shows that retinal neurons can rewire themselves. The body appears to be trying to preserve vision. The findings reveal how retinal circuits adapt at different disease stages. This discovery may guide the development of therapies to slow vision loss.

Rod bipolar cells are neurons that receive signals from rods that provide night vision. Cones provide daytime vision. Researchers found that rod bipolar cells can form new functional connections with cones when their usual partners stop working.

Targeted Nutrients

Alpha-lipoic Acid

150mg–300mg per day. The alpha-R form is the most highly absorbed form with 300mg of standard alpha-lipoic acid that contains 150mg of the natural R form and 150mg of the unnatural S form. Researchers have noted that because patients with RP have signs of ocular oxidative stress without signs of systemic oxidative stress, lower levels of antioxidants may contribute to RP progression; therefore, antioxidants may be helpful. ³ Nicknamed the “universal” antioxidant, alpha-lipoic acid increases glutathione levels in cells that are already within a normal range. It also has potent antioxidant actions. ^{4 5 6} Alpha-lipoic acid also acts as a cofactor for important enzymes—specifically, the alpha-keto acid dehydrogenases—that play a crucial role in helping mitochondria convert food and oxygen into cellular energy. ^{7 8 9}

DHA

600mg, 2 times per day. Taken along with vitamin A. One study’s findings predicted that, if someone at age 37, with typical retinitis pigmentosa starts taking 15,000 IU/day of vitamin A and eats one-or-two 3-ounce servings of omega-3-rich fish per week, they would not lose all central vision until the age of 78. If the average RP patient eats less than 1–2 three-ounce servings of omega-3-rich fish per week, they are predicted to lose all central vision by the age of 59. ¹⁰

Vitamin A Palmitate

In a literature review, researchers found that daily vitamin A (15,000 IU) has a small effect in slowing retinitis pigmentosa progression. Lutein and beta-carotene are vitamin A precursors that also show some benefit. ¹¹ Vitamin A combined with fish oil is helpful. ¹² Be careful to avoid excessive amounts of vitamin A, as this is toxic.

Among the richest sources of vitamin A, beef liver is at the top of the list. For those looking for plant-based options, carrots and sweet potatoes are excellent choices, with other good sources including kale, spinach, seaweed, apricots, broccoli, and winter squash. Animal-derived foods like eggs and butter also provide vitamin A.

Green Tea

500mg–750mg per day. The polyphenol compounds of certain green teas and their extracts are potentially neuroprotective in the photoreceptor outer segment and retinal pigment epithelium (RPE). The dosage is about two cups of green tea per day. ¹³

CoQ10

100mg–200mg per day (ubiquinol is a more easily absorbed form). CoQ10 is found in every cell of the body, acts as a powerful antioxidant, and boosts energy production within cells. CoQ10 is a potent antioxidant that helps shield mitochondrial DNA and essential proteins from oxidative damage. In addition to its protective effects, coenzymes like CoQ10 play a vital role in supporting enzymes that are involved in digestion, various bodily functions, and the maintenance of heart and skeletal muscle health. ¹⁴

Lutein, Omega-3 Fatty Acids, Zeaxanthin, and Astaxanthin

Researchers have suggested that it can be useful for patients with retinal degeneration, including retinitis pigmentosa, to supplement with nutrients such as vitamin A, lutein, omega-3 fatty acids, zeaxanthin, and astaxanthin. While these nutrients are not a cure, they may slow progression ^{15 16 17} and vision loss. ^{18 19 20}

Saffron

20mg per day. Studies have shown that supplementing with saffron helps protect photoreceptor cells from damage as well as support healthy circulation in the retina. ^{21 22} Although these studies were focused on macular degeneration, they may be relevant to RP.

Microcurrent Stimulation for Retinitis Pigmentosa Inflammation

Our bone marrow releases adult stem cells in response to chemical signals produced by injured tissues. The products of inflammation that accompany injury not only serve to trigger the release of adult stem cells but also serve to guide the circulating adult stem cells to the area of injury. One theory is that in chronic diseases like macular degeneration, retinitis pigmentosa, and Stargardt disease, there is often very little or no inflammation present, and therefore there is nothing to signal to the adult stem cells to let them know where the damaged cells are that need to be repaired. Perhaps the microcurrent stimulation serves as a signal to circulating adult stem cells, and it attracts them to the area that is being treated.

The research on microcurrent stimulation suggests that it improves small vessel circulation in the areas treated, restores the normal intracellular-extracellular membrane potential that we discussed earlier, appears to improve lymphatic flow, and it improves something called nerve conduction velocity. All of these effects essentially make the tissues that are treated more normal and healthier, and much of the positive effect we see with microcurrent stimulation may be due to the many things it does to restore normal functioning. Healthy tissue is better able to repair itself, and repair and regeneration are always an “inside job.”

Suggested Supplements

Related Home Device

Microcurrent Stimulation 100ile Purchase Option –  home unit for supporting retinal and optic nerve health. Summaries of 7 studies done to date summarized on the product page.

Related Supplement Packages

Retinal Support RP Package 1 (3 month supply)

Retinal Support RP Package 2 (3 month supply)

Supplements

Advanced Eye & Vision Support Formula (whole food) 60 vcaps – this formula is whole food, organic and GMO free with lutein, zeaxanthin, bilberry, and much more.

Dr. Grossman’s Meso Plus Retinal Support and Computer Eye Strain Formula with Astaxanthin 90 vcaps  – also contains lutein, zeaxanthin, meso-zeaxaanthin, taurine and more.

Advanced Eye & Vision Support & Meso Plus Formula with Astaxanthin (3-mo. Combo)

Dr. Grossman’s Advanced Eye and Dr. G’s Whole Food Superfood Multi120 Vcap Combo – 2 months supply

Dr. Grossman’s Bilberry/Ginkgo Combination 2oz (60ml) 

UBQH 100mg 60 softgels (CoQ10)

Vitamin A Palmitate capsules

Optimized Saffron w/ Satiereal® 60 vcaps

Green Tea 60 lvcaps

NMN Wonderfeel Capsul 60 vegcaps

H2 Elite Molecular Hydrogen 60 tabs

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