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Klopto 5: Omgevingsfactoren, levensstijl, voeding en toxische retina bevindingen van Arjan de Graaf

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Samenvatting van HC 5 van Klopto, met de leerdoelen uitgewerkt.

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Uploaded on
March 28, 2022
Number of pages
8
Written in
2021/2022
Type
Class notes
Professor(s)
Arjan de graaf
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Klopto
5: Omgevingsfactoren, levensstijl, voeding en toxische retina
bevindingen

Accumulatie = ophoping




Cafeïne
Kenmerken:
- Vasoconstrictor
- Remt de ontwikkeling van cataract (antioxidant)
- Geen invloed op de oogdruk wanneer je dit drinkt

Risico door overmatig gebruik:
- Myokymia (onwillekeurig) trillen van spiertjes
- Pupildilatatie
- Toename accommodatie amplitude
- Macula ischaemie


Nicotine

Risico door overmatig gebruik:
- Samen met diabetes kan dit zorgen voor diabetische maculaoedeem vanwege de verzwakte
bloed-retinabarrière
o Bovenste plaatje: normale macula
o Onderste plaatje: diabetische maculaoedeem




- Diabetes Mellitus dus diabetische retinopathie in het algemeen
- AMD (3 tot 4 keer meer kans dan de niet-rokers)
- Cataract (> 15 sigaretten, 3 keer meer kans)
- Glaucoom
- Dry eye syndrome (2 keer meer kans dan de niet-rokers)

, - Vertraagd corneaherstel

Alcohol

Neurotoxine die schadelijk is voor de retina.

Risico door overmatig gebruik:
- Sicca (dehydratie)
- AMD
- DRP?
- C- of BRVO
- CSCR (centraal sereuze chorioretinopathie)
- Cataract

Verschillende medicatie en hun specifieke bijwerking op het oog beschrijven

Plaquenil / hydrochloroquine
Kenmerken:
- Vroeger als anti malaria middel
- Voorgeschreven bij reumatoïde artritis
- Incidentie is zeer traag: 0.5% van de mensen ontwikkelt retina toxiciteit na 5 jaar gebruik
- Kan zorgen voor irreversibele schade aan de visus

Symptomen:
- Meestal asymptomatisch
- Subtieler slechter zicht in het donker
- Verminderd kleurenzien
- Paracentraal scotoom
o Bulls eye maculopathie
o Accumulatie door medicijn rondom macula
o Centrale macula geen accumulatie want de macula is avasculair!




De richtlijn betreffende plaquenil screening uit te leggen

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