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Retinitis Pigmentosa

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Herbs and Supplements to Use Only with Caution

Retinitis pigmentosa (RP) is a group of inherited eye diseases that can lead to severe visual problems. This disorder is named for the irregular clumps of black pigment that occur in the retina.

In most forms of retinitis pigmentosa, cells in the retina called "rods" die. This leads to impaired night vision, as well as a decrease in ability to see things off to the side while looking ahead (peripheral vision). In some forms of RP, other retinal cells called "cones" die. This leads to a decrease in central and color vision. In all forms of RP, vision loss usually progresses over a period of many years. Loss of vision is usually first noted in childhood or early adulthood.

Conventional medicine for retinitis pigmentosa is largely limited to vision aids.

Proposed Natural Treatments for Retinitis Pigmentosa

No natural treatments have been proven effective for retinitis pigmentosa, but some approaches have shown a bit of promise.

The substance lutein is an antioxidant that occurs in the retina. In a small double-blind, placebo-controlled study , 34 adults with retinitis pigmentosa were given either placebo or lutein (10 mg per day for 12 wks followed by 30 mg per day) for 24 weeks. 1 After this period, each group was switched to the opposite treatment, and followed for another 24 weeks. The results indicated lutein supplementation improved visual field as compared to placebo, and also possibly improved visual acuity. However, a larger study will be needed to verify whether these results are meaningful.

A large (over 600 participant) double-blind, placebo-controlled trial found evidence that use of vitamin A supplements at a potentially dangerous dose of 15,000 IU daily might slightly slow the progression of retinitis pigmentosa. 2 However, the benefits seen over the 4-6 year study period were modest at best. A subsequent study by the same researchers evaluated whether adding 1200 mg daily of DHA (a component of fish oil ) along with vitamin A produced better results. 3 Unfortunately, the results of this trial were largely negative. However, in another trial involving in 225 adults, adding lutein (12 mg per day) to vitamin A over 4 years modestly slowed the rate of visual loss in the mid-peripheral field. 4

Herbs and Supplements to Use Only With Caution

In the large vitamin A study noted above, some participants were given vitamin E at a dose of 400 IU daily. The results indicated that use of vitamin E at this dosage might actually speed retinal damage rather than slow it. Until these results are clarified, people with retinitis pigmentosa should avoid taking high dosages of vitamin E. (The daily requirement for vitamin E is far lower than this: 33 IU daily for most adults.)

Revision Information

  • 1

    Bahrami H, Melia M, Dagnelie G et al. Lutein supplementation in retinitis pigmentosa: PC-based vision assessment in a randomized double-masked placebo-controlled clinical trial [NCT00029289]. BMC Ophthalmol 2006 Jun 7 [Epub ahead of print]

  • 2

    Berson EL, Rosner B, Sandberg MA et al. A randomized trial of vitamin A and vitamin E supplementation for retinitis pigmentosa. Arch Ophthalmol. 1993;111:761-72.

  • 3

    Berson EL, Rosner B, Sandberg MA, et al. Clinical trial of docosahexaenoic acid in patients with retinitis pigmentosa receiving vitamin A treatment. Arch Ophthalmol 2004;122:1297-1305.

  • 4

    Berson EL, Rosner B, Sandberg MA. Clinical trial of lutein in patients with retinitis pigmentosa receiving vitamin A. Arch Ophthalmol. 2010 Apr;128(4):403.