Occult macular dystrophy (OMD) is a rare inherited degradation of the retina, characterized by progressive loss of function in the most sensitive part of the central retina (macula), the location of the highest concentration of light-sensitive cells (photoreceptors) but presenting no visible abnormality. "Occult" refers to the degradation in the fundus being difficult to discern. The disorder is called "dystrophy" instead of "degradation" to distinguish its genetic origin from other causes, such as age. OMD was first reported by Y. Miyake et al. in 1989. Symptoms
Symptoms entail a loss of visual acuity in both eyes, including darkened vision, ring scotoma (ring of blindness close to the center of vision), color blindness, and difficulty with bright lights. The scotoma may cause text slightly away from the center of vision to disappear; the appearance would not be black (in early stages) but of the same color as the nearby background. Many lines of an Amsler grid would be faded or invisible to the patient. The area of invisibility on the Amsler grid spreads with time. Symptoms do not include headaches or eye pain. The loss of acuity tends to be symmetric between the eyes. Etiology
OMD that is caused by mutations of the retinitis pigmentosa 1-like 1 (RP1L1) gene (OMIM 608581) is called Miyakes disease. While the mutation is dominant, OMD may manifest more strongly and earlier in children than in the parent (anticipation). However, cases have presented with no mutation to RP1L1.
Becaplermin (brand name Regranex) is a cicatrizant, available as a topical gel. Regranex is a human platelet-derived growth factor indicated along with good wound care for the treatment of lower extremity diabetic neuropathic ulcers. It is also known as "platelet-derived growth factor BB". Medical uses
The drug is used for the treatment of diabetic foot ulcers. Studies of becaplermin showed that when used with good wound care, complete healing significantly increased and the ulcers healed on average 6 weeks faster. Pharmacoeconomic studies reinforce the cost effectiveness of becaplermin as an adjunct to good wound care.The amount of becaplermin to be applied will vary depending upon the size of the ulcer area. Becaplermin should be stored in the refrigerator. Analysis of healing human wounds showed that PDGF-BB induces fibroblast proliferation and differentiation and was found to increase healing in patients with decreased healing capacity, such as people living with diabetes. Contraindications
Becaplermin must not be used at the site of a skin cancer. Adverse effects
The most common side effects in clinical studies were erythematous rashes.A boxed warning has been added to the safety label to describe an increase rate of death from cancer when three or more tubes are used. Regranex should be used with caution in patients with known malignancy. See also
Nepidermin

References
External links
Regranex website