Inflammation of the retina (retinitis) is one of those eye infections that can be particularly insidious for our visual organs.This eye disease cannot always be treated completely and then, or if it is not treated at all, leads to degenerative processes in the eye that can end in complete blindness.The type of retinitis is decisive for the success of the treatment.In addition, there are a number of measures, especially in the area of ​​nutrition, which can have a decisive influence on the course of the disease, despite limited therapy options.Furthermore, there are now new advances in genetics that can help patients with genetic retinitis in particular.This article provides you with details on this and useful information on current therapy standards.Retinitis is such a dangerous condition primarily because it affects a crucial part of the eye that is essential to our ability to see, the retina.It is it that converts the images perceived by the eye into nerve impulses that are then sent to the brain.The quality in which we perceive our environment and the details within it is largely determined by the image transmission of the retina.Damage here can not only contribute to blurred vision, but in the worst case even completely disable the adequate transmission of image signals.Retinitis can be very dangerous for our eyes, so it must be treated, because if left untreated, it can lead to complete blindness.(Image: julia_diak/fotolia.com)To understand how retinitis can impair vision, it is necessary to take a closer look at the unique structure of the eye. The retina here almost completely encloses the eye, with the only gap shown being the lens in the front of the eye will.There the retina separates the eye lens in the edge area from the iris and the cornea.While the cornea is responsible for refraction of the light rays entering the eye from the outside, the iris (cornea) forms the individually colored part of the eye around the black pupil of the eye, which, in addition to visual acuity, is primarily responsible for light entering the eye appropriate intensity falls through the pupil onto the retina.Depending on the light conditions, the iris narrows or widens for this purpose, resulting in a smaller or larger area of ​​the pupil.Two muscles are essential for this, which together produce the play of the pupils.As soon as the light entering the eye from outside has passed the cornea and iris and has reached the pupil, it enters the vitreous body (corpus vitreum).This round part of the eye not only gives it its typical shape, but also forms the section in which the previously scattered light is focused again before it falls on a very specific part of the retina.The so-called yellow spot (macula lutea) is also the zone where the retina merges into the optic nerve.However, before the perceived images reach the brain via the optic nerve, the light signals picked up by the yellow spot are first evaluated by the diverse nerve cells of the retina and converted into nerve impulses.Depending on their function, these cells can be divided into different groups:The retina at the back of the eye is not surrounded by the iris and cornea, but by two eye membranes attached to these skin layers.The choroid lies directly above the posterior retina, the vessels of which ensure the supply of nutrients to the retina.The choroid is connected to the iris via the ciliary body (corpus ciliaris).On the one hand, it serves as a suspension for the lens of the eye and, on the other hand, is also involved in the production of aqueous humor and tear fluid.The cornea of ​​the eye, on the other hand, merges directly and practically seamlessly into the sclera in the rear of the eye.It envelops the choroid and retina like a protective layer and thus protects the two underlying eye membranes from damage.Like the retina, the choroid and sclera also open into the optic nerve.The retina occupies a special position among the different types of eye skin because it is the only one with an independent skin envelope. (Image: Alexandr Mitiuc/fotolia.com)In this all sorts of eye membranes, the retina occupies a special position not only in terms of its function and thus metaphorically speaking, but also literally.Because in contrast to all other eye membranes, it is the only one that represents an independent skin envelope that extends from the front to the back of the eye:As the above explanation of the structure of the retina shows, retinitis can develop in different places.Various elements of the retina can also be affected by the inflammation.For example, inflammation of the blood vessels in the retina is conceivable.This is also referred to as retinal vasculitis.Inflammatory processes in the nerve cells of the retina are also conceivable.They are usually caused by congenital cell defects and have so far been difficult to treat.In view of the different ways in which it develops, a distinction is made between several forms of retinal inflammation:Retinitis is caused by an existing pre-infection.A special subspecies in this regard is retinitis syphilitica, which is triggered by the pathogens of syphilis and is considered a special complication of this infectious disease.In some cases, an injury to the retina preceded this, through which infectious agents could then penetrate into the retinal tissue.Very often, retinitis is accompanied by simultaneous inflammation of the choroid.The choroidal inflammation can also appear as the cause of retinitis.This is a congenital eye disease in which there is inflammation of the outer vessels of the retina.The disease is one of the retinal vasculitides.Since the inflamed blood vessels become leaky in the course of the disease, there is a secretion (exudation) of vascular water or even blood in the retina.Also defined as retinal vasculitis, this retinal vasculitis occurs primarily in young men between the ages of 20 and 30.In addition to vascular inflammation in the area of ​​the retina, Eales syndrome can also lead to vitreous hemorrhage.This is a particularly dangerous, hereditary form of retinitis, which leads to episodes of retinal inflammation and later to the destruction of retinal tissue.In this form, only the central area of ​​the retina is affected, but this also describes the area of ​​the yellow spot.Even though central retinitis remains localized, it poses a serious threat to vision.Retinitis is particularly dangerous when it affects the yellow spot.As the direct interface between the eye and the optic nerve, inflammation of the macula lutea inevitably results in a massive visual impairment.In addition, damage to this area of ​​the retina is almost always irreversible, leading to permanent vision loss.Important: Although the treatment measures for retinitis are often limited, treatment should nevertheless take place under all circumstances and also at an early stage!If there is no suitable therapy, retinal inflammation results in permanent damage to the sensitive retina.It is not uncommon for this damage to end with a complete loss of vision because the images perceived can no longer be correctly converted into nerve impulses!Surprisingly, retinitis is relatively often triggered by general infections that at first glance have nothing to do with the eye.However, infectious agents can very easily get into the eye from a remote part of the body via the bloodstream.The retina is particularly at risk here because it is surrounded by the vascularized choroid at the back of the eye.On the other hand, the retina itself has numerous blood vessels, which particularly favors the transfer of the pathogens from the vein to the retina.Last but not least, chorioretinitis also comes about in this way.Herpes, for example, is one of the typical infectious diseases that are considered the main cause of retinitis.(Image: blackday/fotolia.com)From bacteria to fungi to viruses, numerous infectious agents can be responsible for retinitis.Typical infectious diseases that are considered the main cause of retinitis include:It may take some time for visual disturbances associated with these infections to show up as a sign of retinitis.But these are often all the more obvious.It is no secret that inflammation spreads further and further in the body if left untreated.Of course, this also applies to the eye, where the retinal inflammation is occasionally preceded by a protracted inflammation of the overlying skin layers.In particular, inflammation of the middle layer of the eye (uveitis) is often involved in the development of retinitis.Of course, local inflammations such as iris inflammation (iritis) or the already mentioned choroidal inflammation (chorioditis) can spread to the retina.With regard to vascular inflammation, it can be said that retinal vasculitis often goes back to an existing vascular disease, such as arteriosclerosis or diabetes mellitus.In this regard, diabetes mellitus can even provoke diabetic retinopathy (Retinopathia diabetica).This is a disease of the retina caused by diabetes, which is associated with progressive damage to the retinal vessels.Inflammatory processes and retinal damage, which can lead to blindness, are not excluded with this disease.Genetic factors or at least autoimmune diseases caused by genetic predisposition play a major role in many forms of retinitis.The best example here is retinitis pigmentosa.The disease is characterized by a progressive mutation of the photoreceptors in the retina, which initially provokes inflammatory processes, visual impairment and night blindness, later also an increasing loss of the visual field and finally complete blindness.With the onset of a new flare-up of the disease, the patients feel a strong burning sensation in the eyes, which announces the inflammatory tissue destruction of new parts of the retina.According to the current state of medical research, defects in one of around 60 to 100 different genes can be the cause of retinitis pigmentosa.These are mainly assigned to the X chromosome and are responsible in the eye either for basic genetic processes such as the maintenance and development of tissue or for the creation of cell structures.But they also take on very specific tasks in the retina, such as the conversion of light stimuli (phototransduction) or metabolic processes in the retina.Initially, mutations lead to disorders related to the affected genes and their function.In the further course, however, each of these disturbances inevitably ends with the destruction of the photoreceptive cells.A particular focus of the cause of retinitis pigmentosa is also on the so-called retinal pigment epithelium (stratum pigmentosum), to which the disease unmistakably owes its name.It forms the boundary layer between the retina and the choroid and is used both for the exchange of substances between the photoreceptors and for filtering or blocking out light signals.Irrespective of skin color, the retinal pigment epithelium is maximally pigmented in every human being and is therefore almost black in order to be able to function as a shadowing light filter.In this regard, defects in said pigment cells occur in particular in people with very light skin or red hair, since there is already a special genetic predisposition to reduced melanin production.Caution: In about 25 percent of all cases, retinitis pigmentosa occurs in combination with other genetic diseases.This includes, for example, Usher syndrome, an autosomal recessive inherited hearing-sight impairment, which is characterized by hearing loss starting in early childhood or even congenital deafness.In the later course of the disease, the classic flare-ups of retinitis pigmentosa also set in.Other conceivable comorbidities of retinitis pigmentosa are Bardet-Biedl syndrome, Refsum syndrome, NBIA syndrome, Alport syndrome and Saldino-Mainzer syndromeIn the case of exudative retinitis, known as Coats' disease, on the other hand, the causative gene defect is often based on a disrupted synthesis or function of the signaling molecule VEGF (vascular endothelial growth factor).The protein originates from the 6th chromosome and is responsible for the production of nitrogen monoxide in the vessel walls, which stimulates the dilation of the blood vessels and thus prevents high blood pressure.On the other hand, VEGF molecules also stimulate the formation of new blood vessels (angiogenesis) and the production of immune cells (macrophages and monocytes) in the blood.Defects in the VEGF gene not only result in degeneration of the blood vessels, but also increase the risk of infections and inflammations because the production of immune cells is significantly reduced.The scientific knowledge of the genetic causes of retinitis is still in need of much improvement.Eales syndrome, also known as retinitis proliferans, proves this.The exact background to the genesis of the disease is still relatively unexplored, with experts suspecting an interaction of several factors.In addition to the tuberculosis pathogen Mycobacterium tuberculosis and oxidative stress, congenital autoimmune processes and possible blood clotting disorders in the form of coagulopathy are also discussed as possible influencing factors.As is well known, a particular focus of inflammation and infection can arise from injury wounds.However, a retinal tear does not only occur in the case of injuries caused by foreign bodies in the eye or in the event of external violence.Cracks are much more often the trigger, through which fluid spreads out of the inside of the eye.Again, we refer to exudative retinitis.The already mentioned, congenital genetic defect causes leaks in the blood vessels of the retina, which means that large amounts of vascular fluid leak into the surrounding tissue.If the retinal inflammation in this form of retinitis is not already present due to existing vascular inflammation, it will then occur at the latest, and the increased fluid pressure can cause retinal tears.These in turn cause an increased risk of inflammation, especially in view of the increased risk of infection that the genetic defect in exudative retinitis brings with it.Another danger is a tear in the retina caused by a leaking vitreous body.It consists of about 90% water, which is why injuries to the corpus vitreum can lead to a similarly dangerous escape of fluid as leaky retinal vessels.An increasing pressure load on the retina, which causes tears or retinal detachment as a result, cannot be ruled out even in the case of vitreous body damage.Although retinitis pigmentosa is usually caused by congenital genetic defects, it can occasionally be due to acquired damage to the retina.This is the case, for example, with UV damage caused by extreme solar radiation in the eyes.Damage to the pigment-producing layers of the retina can be similar to that caused by a genetic defect.In addition, radiation damage from UV light also increases the risk of tumors.Since the corresponding cell degenerations are unnaturally space-occupying, they increase the pressure conditions in the eye, which is why pressure-related tears in the layers of the eye skin definitely pose a risk.And even extreme pressure effects, such as those that occur during diving, cannot be completely ruled out as the cause of a retinal tear.The symptoms of retinitis are usually the same, regardless of the different ways it originates.In addition to typical signs of inflammation such as redness and tissue swelling, a deterioration in vision that sets in gradually and gets progressively worse is characteristic.At the beginning, the visual problems manifest themselves primarily in increasing night blindness and limitations in the field of vision (tunnel vision).As the disease progresses, affected eyes react more and more sensitively to bright light conditions and show disturbances in contrast and color vision.At the end of this process, in the final stage of the disease, there is complete loss of vision.A symptom of retinitis is retinal detachment, which creates a strong foreign body sensation in the eye.(Image: Henrie/fotolia.com)Individual episodes of retinitis are usually noticeable by a noticeable burning sensation in the eyes.This can increase in intensity as the disease progresses.In addition, the retinal damage caused by the disease can also lead to a retinal detachment, which then creates a strong foreign body sensation.Overall, the following symptoms are conceivable with retinitis:Attention: The risk of blindness is increased in forms such as retinitis pigmentosa by the fact that glaucoma manifests itself in many patients in the advanced stage.The disease is characterized by a loss of nerve fibers in the eye, which further accelerates an existing deterioration in vision.Thanks to modern diagnostic measures, retinitis can be detected at an early stage.Congenital forms of the disease can also be detected in early childhood, provided parents know how to interpret existing symptoms in good time.After an initial anamnesis, eye tests are usually carried out first in order to be able to determine disease-related visual problems such as night blindness, reduced visual acuity or disorders in color perception.Likewise, in most cases, an electrodiagram (ERG) is performed as standard.The eye is exposed to targeted light stimuli in order to electronically record the subsequent reactions of the retina.If a genetic cause is suspected behind the retinitis, a genetic diagnosis must also be carried out after the eye examinations.In the past, this was usually done using DNA analysis, with the help of which corresponding gene mutations can be made visible in the laboratory.There are now also more modern diagnostic approaches such as the DNA or protein chip, some of which are still under development.In addition to the laboratory tests, the doctor treating the patient (and their parents in the case of children) draws up a family tree that helps to determine how the causative genetic defect was inherited.Collecting such information is also important for further research on retinitis, since many questions about the genetic background of the disease are still unanswered.While infection-related retinitis can be treated relatively easily if therapy is started in good time, it looks a little more problematic with genetic and injury-related retinal inflammation.The irreversible damage that has already occurred to the retina in such cases, or that has existed since birth, can only be reversed to a limited extent or not at all.However, there are some measures that can be taken to at least slow down the course of the disease.In addition, scientists have reported clear breakthroughs in the field of genetics in recent years when it comes to treating forms of illness such as retinitis pigmentosa.For details, please refer to our overview of possible treatment measures below: In most cases, eye drops are administered first in the case of retinal inflammation caused by a fungal infection.(Image: metamorworks/fotolia.com)In the case of retinal inflammation caused by a bacterial pre-infection, the only thing that generally helps is taking antibiotics..For bacterial infections, doctors usually use a broad-spectrum antibiotic.In the case of viral infections, antivirals help, while fungal infections are treated with antifungal drugs.The active ingredients are usually used in the form of eye drops for retinitis.In the case of particularly severe courses, however, direct injection into the eyeball using a syringe is also conceivable.If previous illnesses such as diabetes mellitus or high blood pressure are responsible for the retinitis, specific medication (insulin and blood pressure medication) must of course be taken in order to be able to treat the retinitis as a secondary disease.In addition, decongestant and anti-inflammatory drugs can be considered, whereby immunosuppressants such as prednisolone, azathiprine and cyclosporine, which have a targeted local effect, are clearly preferable to aggressive cortisone preparations.In the past, there have been various drug treatment approaches for genetically motivated retinitis.For example, attempts have been made to slow down the course of the disease with vitamin A preparations, since the vitamin strengthens the retina to a particular extent.Valproic acid, which is commonly used to treat epilepsy, seizure disorders and bipolar disorders, has also shown positive results in studies in the treatment of various hereditary diseases, including retinitis pigmentosa.However, priority is currently being given to the further development of gene and stem cell therapies for the treatment of genetic causes of retinitis, and with considerable success.For example, a gene therapy against the defective gene RPE65 was discovered a few years ago.The protein is involved in the transmission of light signals in the retina and is one of the genes that can be responsible for retinitis pigmentosa.A first successful therapy in this regard was already carried out in 2009 by the human geneticist Dr.Robin Ali performed.At University College in London, thanks to an injection of the gene, he was able to successfully improve the vision of a then 19-year-old German who was suffering from retinitis pigmentosa.The RPE65 gene therapy was finally officially approved by the Food and Drug Administration FDA in the USA.Robin Ali and his research team received the Campalimaud Vision Award for their discovery in September this year.And for another gene called PDE6ß, which has been shown to be able to trigger retinitis pigmentosa, gene therapy is currently being tested.Since the summer of 2018, the Nantes University Hospital has been carrying out a test treatment on 12 patients in whom a mutation in the gene triggers the retinitis.The so-called Horama therapy comes from France and is another promising method for treating genetic retinitis that gives those affected new hope.As an alternative to gene therapy, there is also the option of stem cell therapy in this context, in which the damaged genes are replaced with healthy ones.However, this requires a life donor with the right genetic material, and the injection of stem cells into the spinal cord is not without the risk of complications.Although previous treatment models for curing genetic retinitis appear to be clearly superseded by the latest options in gene therapy, at least the vitamin A therapy approach still has a reason to exist.For symptoms such as night blindness, a diet rich in vitamin A, such as kiwis, can help.(Image: khumthong/fotolia.com)Because the vitamin improves the conversion of light signals into nerve impulses, which can help with retinitis, especially with symptoms such as night blindness.A diet specifically rich in vitamin A, for example through foods such as:can actually have a positive effect on the course of the disease.A diet low in phytanic acid is also indicated for retinitis pigmentosa as a side effect of Refsum's syndrome.The syndrome is based on a metabolic disorder in which the fatty acid phytanic acid cannot be broken down and is therefore increasingly stored in the blood vessels.In this case, retinitis is the result of increasing and inflammatory arteriosclerosis in the area of ​​the retina and choroid vessels.This acid is mainly contained in high-fat milk and meat products, but also in fish and seafood, which is why these should always be selected according to their actual phytanic acid content.Medicinal plants for retinitis come mainly from Traditional Chinese Medicine (TCM).Here the disease is seen as the result of an imbalance in the Liver and Kidney Qi.At least associations with the liver are not entirely unreasonable here, since the organ is involved to a large extent in blood purification and disorders consequently also affect the blood supply and vascular health of the eyes.Herbs that regulate the flow of Qi in the liver and kidneys are recommended.Which includes:Important: We expressly point out that Chinese herbs must always be prescribed and dosed by specialists experienced in TCM!Another measure to slow down the progression of the disease is hyperbaric oxygen therapy. Patients are specifically administered pure oxygen while they are exposed to increased ambient pressure for a certain period of time.There are special facilities for this, which have the necessary pressure chambers.As a last resort, artificial retinal implant transplantation to replace the patient's damaged retina should also be possible in the near future.This has already been tested in initial studies, but the process is not yet fully developed.(ma)This text corresponds to the requirements of medical specialist literature, medical guidelines and current studies and has been checked by medical professionals.Important note: This article contains general information only and should not be used for self-diagnosis or treatment.He can not substitute a visit at the doctor.The specialist portal for naturopathy and health