Case Study: Retinitis Pigmentosa Treatment with coMra Therapy and Microcurrent

Practitioner Background

• Optometrist and Occupational Therapist
• Specializes in visual rehabilitation (post-stroke, head trauma, low vision)
• Works with retinitis pigmentosa, macular degeneration, diabetic retinopathy
• Focuses on rehab and vision therapy

Patient Profile

• 57-year-old African-American female
• Diagnosed with retinitis pigmentosa (RP) in March 2014
• History of arterial venous malformation (AVM) bleed
• HIV positive and borderline Type 2 diabetic

Initial Symptoms

• Diminishing peripheral and inferior vision
• Difficulty with night vision and light adaptation
• Frequent tripping and falling

Initial Assessments

• Visual acuity: 20/30 (-/+)
• Significantly depressed contrast sensitivity
• Moderately impaired color vision
• Impaired depth perception (200 seconds of arc)
• Severely impaired Goldman visual field
• OCT showed severe loss in retinal layers
• ERG showed severely reduced retinal activity

Diagnosis

• Severe, diffuse outer retinal dysfunction affecting rods and cones
• Atypical scalloped-gyrate atrophy
• Possible choroideremia
• Atypical RP presentation (late onset, no family history)

Treatment Protocol

Phase 1: Microcurrent Therapy

• Frequency-specific microcurrent (FSM)
• 5 treatments, once a week, 37 minutes each
• Electrode placement: transpalpebral and behind neck

Phase 2: Combined coMra and Microcurrent Therapy

• 14 sessions combining coMra and FSM
• coMra protocol evolution:

1. Universal 1 (1 minute lateral aspect)
2. Added optic neuritis protocol (scanning above/below orbital ridge)
3. Final protocol: 1 min Universal 1, 2 min optic nerve protocol, 1 min lateral, 1 min superior

Treatment Outcomes

Visual Field Improvements

• Significant expansion of visual fields in both eyes
• Documented through stereocampimeter and Goldman visual field tests

Other Improvements

• Visual acuity improved to 20/20 in each eye
• Normalized contrast sensitivity
• Improved depth perception (63 seconds of arc)
• Improved color vision
• ERG showed some responses now present (30 Hz flicker)

Subjective Improvements

• Better emotional state
• Increased peripheral vision
• Improved depth perception
• Reduced tripping and falling
• Increased confidence in mobility

Long-term Management

• Initially reduced to bi-weekly treatments, but saw decline
• Resumed twice-weekly treatments
• Some recovery, but not to initial peak gains
• Ongoing treatment to maintain vision as long as possible

Significance

• Unusual and extraordinary recovery for RP
• Typically, RP leads to progressive vision loss without improvement
• External validation from UCSF ophthalmologist