Bridging extra large defects of peripheral nerves: possibilities and limitations of alternative biological grafts from acellular muscle and Schwann cells.

Experiments on photic damage to the retinas of rats with hereditary retinal dystrophy and some tentative clinical evidence on human patients suggest that, in human retinitis pigmentosa, one could try to protect the retina and especially the rods from bright light in an attempt to delay the retinal degeneration and to prolong the period of useful vision. Several theoretical criteria have been proposed for protection of RP patients from possible photic retinal damage. Observing these criteria, Adrian developed a brownish ophthalmic filter which absorbs the short wavelengths preferentially, thus protecting the rods primarily. Whether or not use of these filters will be efficacious has yet to be determined and will require careful experimentation and the accumulation of clinical experience. Several brown ophthalmic filters also have been tested against the criteria for a protective device. The NoIR Amber 7% plastic glasses satisfy these criteria quite well and thus can be considered as a substitute for the Adrian lens. The characteristics of the two types of filters are compared. Experience with different methods of protection may show whether it is better to attempt to delay degeneration of both retinas simultaneously by decreasing their illuminations with filters or to exclude light completely from one eye in an attempt to preserve it while the other eye degenerates in the usual course of the disease. In any event, given the present state of knowledge, it seems to be appropriate, especially in the early stages of the disease, to suggest that RP patients protect their retinas from excessive light.