In retinitis pigmentosa as described, what happens to photoreceptors?

• A. They die faster due to inefficient waste filtration causing clogging
• B. They regenerate rapidly
• C. They migrate toward the optic nerve
• D. They become more pigmented

Answer: (A)

In retinitis pigmentosa the photoreceptors progressively die off, and this process can be driven by impaired clearance of cellular waste in the retina. The idea being tested is that specialized waste-filtration by supporting cells (the retinal pigment epithelium, which constantly phagocytoses shed outer segment discs) becomes inefficient or clogged. When this waste removal slows or fails, toxic debris and metabolic byproducts accumulate, stressing the photoreceptors and triggering their death. This explains why photoreceptors die faster over time, leading to the characteristic loss of peripheral vision and night vision in RP.

Context helps: photoreceptors rely on the RPE for maintenance and debris clearance. If that process is compromised, the resulting environment becomes detrimental to photoreceptors, accelerating degeneration. Over the course of the disease, the outer retina thins and vision deteriorates further. Pigmentary changes in RP stem from RPE responses, not from the photoreceptors becoming more pigmented themselves. The other options describe regeneration, migration, or pigment changes in the photoreceptors themselves, which do not fit how RP typically progresses.