Incipient atrophy is demarcated by areas of retinal pigment epithelium ( RPE ) thinning or depigmentation that precede geographic atrophy in the early stages of AMD . In advanced stages of AMD, atrophy of the RPE ( geographic atrophy ) and / or development of new blood vessels ( neovascularization ) result in death of photoreceptors and central vision loss.
32.
Glutathione can be combined with many other agents like vitamin C to increase its absorption, N-acetyl cysteine to boost its level, and other antioxidants like vitamin E . Some oral intake of glutathione could have dangerous effect when combined with other skin whitening agents such as hydroquinone which is a carcinogenic element and monobenzone which causes irreversible depigmentation.
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In the first case study of the Kurdish girl, researches described her as having albinism and a black lock at the right temporo-occipital region along Blaschko lines, her eyelashes and brows were white, the irises in her eyes appeared to be blue, she had spots of retinal depigmentation, and she did not react to noise . The albinism is interesting in this diagnosis because the skin of an affected individual is albino pale besides the brown patches of mispigmented skin.
34.
No longer considered a separate syndrome, ABCD syndrome is today considered to be a variation of Shah-Waardenburg type IV . Waardenburg syndrome ( WS ) is described as the combination of sensorinerual hearing loss, hypopigmentation of skin and hair, and pigmentary disturbances of the irides . Hearing loss and deafness, skin mispigmentation and albinism, and pigmentary changes in irises are the similarities between WS and ABCD . According to a dictionary of dermatologic syndromes, Waardenburg syndrome has many notable features, including depigmentation of hair and skin-white forelock and prematuring graying of hair, confluent thick eyebrows, heterochromic irides or hypopigmentation of iris, laterally displacy inner canthi, congenital sensorinerual deafness, broad nasal root, autosomal dominant disorder, and other associated findings, including black forelocks .
