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Is there evidence supporting the Cuban treatment for RP ?

Duquette, J. (2010). Is there evidence supporting the Cuban treatment for retinitis pigmentosa ? Information monitoring summary. Longueuil : INLB. 10 pages.

Retinitis pigmentosa (RP) is a heterogeneous group of chronic, progressive genetic vision disorders. It causes gradual deterioration of photoreceptor cells in the retina, mainly affecting the rods, which are responsible for night vision. Gradual loss of the peripheral visual fieldoccurs until only central vision remains, followed by cone degeneration which may eventually result in total blindness.

Treatment in Cuba for RP patients comprises eye surgery, ozone therapy, electrostimulation and drugs. In 2009, initial treatment of RP involved three weeks’ hospitalization and apparently cost just over $10,000; each subsequent six-monthly ozone treatment was costing around $4,900. According to the Cuban physicians, the goal of the procedure is to increase blood flow in the degenerating portion of the retina and thereby stabilize the disease . However, according to l’Association des médecins ophtalmologistes du Québec, the scientific claims on which this treatment is based are erroneous, because retinitis pigmentosa is a cellular disorder unrelated to blood circulation. Moreover, post-operative complications have been reported in the literature. As regards ozone action, its mechanisms and effects are neither clear nor fully understood at the theoretical level.

A Cuban study has concluded that ozone treatment is worth administering at six-monthly intervals to patients in the early stages of RP. However, no longitudinal studies have been published about the long-terms effects of repeating this treatment every six months. In addition, these conclusions are based purely on visual field measurements, which are subjective. The fact that no objective measurements have been conducted using an electroretinogram substantially weakens the study’s validity. The study results were published in Ozone : Science & Engineering, which is not a medical scientific review. However, critical review and analysis by peers, e.g. independent, impartial retina specialists, are key in establishing the acceptability of a study and ensuring the advancement of science. No independent studies have demonstrated that the Cuban treatments improve or stabilize retinal function in the long term. Berson et al. (1996) even suggested that these interventions could aggravate the disorder.

Because the Cuban protocol has not been subject to critical analysis, many major authorities in the ophthalmologic field, including the Canadian Ophthalmological Society, l’Association des médecins ophtalmologistes du Québec, the RP Research Foundation in Canada and the Foundation Fighting Blindness in the U.S., as well as various authors and researchers, are questioning these treatments or regard them as pointless.

Sujets : Rétinite pigmentaire; Thérapeutique; Cuba

Type de document : Recension des écrits

Aussi disponible en français sous le titre : Existe-t-il des données probantes quant au protocole de traitement offert à Cuba pour les personnes ayant une rétinite pigmentaire ?

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