Ayurvedic management of Stargardt disease: a case report

Abstract

Stargardt disease is the most common form of inherited juvenile macular degeneration which causes progressive vision loss. Mutations in ABCA4 gene cause the production of dysfunctional protein that cannot perform energy transport to and from photoreceptor cells in the retina and the photoreceptors in turn undergo degeneration causing vision loss. Symptoms typically develop in the rst to second decades with bilateral, gradual impairment of central vision which may be out of proportion to the macular changes, so that the child may be suspected of malingering. Though the disease is considered rare, it is not so uncommon and is very troublesome to the affected. The most alarming part of this disease is that there are no treatments available in modern ophthalmology. Using magniers and sunglasses may give some relief. The role of Ayurveda is crucial in this case in providing some measures to prevent the progression of the disease. From the Ayurvedic perspective, the condition is to be discussed under the concept of Timira-Kacha- Linganasa. The signs and symptoms may contribute to the involvement of tridosha vitiation. If there are changes in the retina which are irreversible, the disease may be considered sannipatika. Here the case of a 15 year old girl is discussed who presented with dimness of vision and increased sensitivity to glare and fundus changes which are suggestive of Stargardt disease. She positively responded to the proposed Ayurvedic management procedure.