Retinal Dystrophy: What It Is, Types, and How They Are Distinguished

The diagnosis of "retinal dystrophy" in an ophthalmologist's report often sounds frightening, although it hides not one disease but a whole group of conditions. The retina is a thin light-sensitive tissue at the back of the eye that captures light and sends signals to the brain. When its cells gradually break down, vision suffers. In retinitis pigmentosa, for example, night and peripheral vision deteriorate first, and later central vision may also be affected.

What retinal dystrophy is and how it differs from degeneration and abiotrophy

In essence, retinal dystrophy, retinal degeneration, and retinal abiotrophy describe a similar process — the slow breakdown of retinal cells. The terms may be used differently in different reports, and the doctor will explain the exact meaning in your case. In hereditary forms, changes in the genes that control retinal cells are passed from parents to children. A well-known example is retinitis pigmentosa: a group of rare hereditary eye diseases in which retinal cells gradually break down.

Types of retinal dystrophy: flecked, non-pigmented, vitelliform

The names of the types often reflect what the doctor sees in the fundus. Medical reference books mention, for example, fundus albipunctatus among hereditary retinal diseases. The non-pigmented form is a name from a classification; its meaning is clarified by the treating ophthalmologist. Vitelliform dystrophy (vitelliform macular dystrophy) affects the center of the retina — the macula, which is responsible for clear vision of fine details.

Congenital retinal dystrophy: how it manifests and where it comes from

Congenital retinal dystrophy is associated with changes in genes that a person receives from their parents. Such diseases are not acquired during life. In hereditary forms such as retinitis pigmentosa, symptoms usually begin in childhood: parents may notice that the child has difficulty navigating in the dark and slowly adjusts to dim light. Sometimes such conditions are part of other genetic syndromes, such as Usher syndrome, in which both vision and hearing are affected. Less commonly, similar changes are caused by certain medications, infections, or eye trauma.

Main symptoms and how vision changes

The most common early sign is loss of night vision. Then the visual field narrows: it becomes difficult to notice objects at the edges until only a central "tunnel" remains. Sensitivity to bright light and loss of color vision are possible. Vision declines at different rates in different people. Here is what you can notice on your own:

• worse vision at dusk and when moving from light to dark;
• objects at the sides "disappear" from the visual field;
• bright light is more irritating than usual;
• colors seem less saturated.

This is not a diagnosis but a reason to see an ophthalmologist.

How retinal dystrophy is detected

The examination begins with a dilated fundus examination: the doctor instills drops that dilate the pupil and examines the retina. Additionally, electroretinography (testing the retina's response to light), optical coherence tomography (a detailed image of the retina), fundus autofluorescence, visual field testing, and fluorescein angiography to assess the vessels are used. Genetic testing may be needed — it helps to understand the type of disease and how symptoms may change over time.

When to see an ophthalmologist

You should make an appointment with an ophthalmologist if you have started seeing worse at night, notice narrowing of peripheral vision, or persistent blurriness. In hereditary retinal diseases, regular examinations help to detect other problems in time — cataract, changes in the center of the retina, refractive errors.

Retinal dystrophy itself is not a reason to call an ambulance. Call 103 or 112 if flashes of light appear, sudden loss or a sharp change in vision, or a sharp increase in the number of "floaters" before the eyes — this may be a sign of a serious retinal problem.

This material is for reference: only a doctor at an appointment can settle the question, so do not delay consultation with an ophthalmologist.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer