The document discusses eye health and common vision problems in children and seniors. It notes that 75% of blindness is preventable or treatable and vision problems affect nearly 13.5 million U.S. children. Common childhood vision issues include nearsightedness, farsightedness, astigmatism, strabismus, and amblyopia. Early detection is important to prevent learning issues or permanent vision loss. Common senior vision conditions include presbyopia, cataracts, dry eye, glaucoma, and age-related macular degeneration. Worldwide, someone goes blind every 5 seconds and 80% of blindness is preventable, with developing nations having far less access to eye care.
Glaucoma is an optic neuropathy characterized by damage to the optic nerve and visual field defects that is frequently associated with elevated intraocular pressure (IOP). It can be primary or secondary. Primary glaucoma involves elevated IOP without another cause, while secondary glaucoma occurs when another eye condition alters aqueous outflow leading to elevated IOP. Glaucoma is classified as open-angle or angle-closure depending on whether the angle between the iris and cornea is open or closed. Pseudoexfoliation glaucoma is a secondary open-angle glaucoma caused by deposits of pseudoexfoliative material clogging the trabecular meshwork. Neovascular glaucoma is also secondary, occurring
Presentation about Floppy Iris Syndrome by David Chang. Excellent talk and worth a read. Posting it for those who may not be members of American Academy of Ophthalmology or just missed it
Diabetic retinopathy presentation intended to refresh the knowledge of ophthalmic nurses, ophthalmic clinical officers and other mid level ophthalmic personnel, and read initially for the self-support diabetes patients group.
Breaking the barriers in the management of neovascular AMDAjayDudani1
The document summarizes key details from two phase 3 clinical trials called HAWK and HARRIER that compared the anti-VEGF drug brolucizumab to aflibercept for treating neovascular age-related macular degeneration (nAMD). The trials involved over 1700 patients across multiple international sites. Patients were randomly assigned to receive either brolucizumab 3mg or 6mg, or aflibercept 2mg. The primary endpoint was change in vision from baseline at week 48, with assessments continuing through week 96. Brolucizumab demonstrated non-inferiority to aflibercept and an ability to be dosed as infrequently as every 12 weeks after the initial
This document discusses Intraoperative Floppy Iris Syndrome (IFIS), which is a complication that can occur during cataract surgery characterized by a floppy iris that billows and prolapses. IFIS is primarily caused by the medication tamsulosin and can lead to surgical complications. The document provides tips for managing IFIS, including preoperative atropine, intracameral epinephrine, Healon 5, and iris hooks or pupil expanders during surgery. A thorough medication history is important to identify patients who may be at risk for IFIS.
Primary open angle glaucoma (POAG) is the most common type of glaucoma. It is characterized by an open anterior chamber angle, optic nerve damage indicative of glaucoma, and visual field loss in the absence of a secondary cause. The major risk factor for POAG is elevated intraocular pressure (IOP) above 21 mmHg. Other risk factors include older age, African ancestry, family history of glaucoma, diabetes, and high myopia. Treatment aims to lower IOP through medications, laser therapy, or surgery to prevent further optic nerve damage and vision loss.
The document discusses eye health and common vision problems in children and seniors. It notes that 75% of blindness is preventable or treatable and vision problems affect nearly 13.5 million U.S. children. Common childhood vision issues include nearsightedness, farsightedness, astigmatism, strabismus, and amblyopia. Early detection is important to prevent learning issues or permanent vision loss. Common senior vision conditions include presbyopia, cataracts, dry eye, glaucoma, and age-related macular degeneration. Worldwide, someone goes blind every 5 seconds and 80% of blindness is preventable, with developing nations having far less access to eye care.
Glaucoma is an optic neuropathy characterized by damage to the optic nerve and visual field defects that is frequently associated with elevated intraocular pressure (IOP). It can be primary or secondary. Primary glaucoma involves elevated IOP without another cause, while secondary glaucoma occurs when another eye condition alters aqueous outflow leading to elevated IOP. Glaucoma is classified as open-angle or angle-closure depending on whether the angle between the iris and cornea is open or closed. Pseudoexfoliation glaucoma is a secondary open-angle glaucoma caused by deposits of pseudoexfoliative material clogging the trabecular meshwork. Neovascular glaucoma is also secondary, occurring
Presentation about Floppy Iris Syndrome by David Chang. Excellent talk and worth a read. Posting it for those who may not be members of American Academy of Ophthalmology or just missed it
Diabetic retinopathy presentation intended to refresh the knowledge of ophthalmic nurses, ophthalmic clinical officers and other mid level ophthalmic personnel, and read initially for the self-support diabetes patients group.
Breaking the barriers in the management of neovascular AMDAjayDudani1
The document summarizes key details from two phase 3 clinical trials called HAWK and HARRIER that compared the anti-VEGF drug brolucizumab to aflibercept for treating neovascular age-related macular degeneration (nAMD). The trials involved over 1700 patients across multiple international sites. Patients were randomly assigned to receive either brolucizumab 3mg or 6mg, or aflibercept 2mg. The primary endpoint was change in vision from baseline at week 48, with assessments continuing through week 96. Brolucizumab demonstrated non-inferiority to aflibercept and an ability to be dosed as infrequently as every 12 weeks after the initial
This document discusses Intraoperative Floppy Iris Syndrome (IFIS), which is a complication that can occur during cataract surgery characterized by a floppy iris that billows and prolapses. IFIS is primarily caused by the medication tamsulosin and can lead to surgical complications. The document provides tips for managing IFIS, including preoperative atropine, intracameral epinephrine, Healon 5, and iris hooks or pupil expanders during surgery. A thorough medication history is important to identify patients who may be at risk for IFIS.
Primary open angle glaucoma (POAG) is the most common type of glaucoma. It is characterized by an open anterior chamber angle, optic nerve damage indicative of glaucoma, and visual field loss in the absence of a secondary cause. The major risk factor for POAG is elevated intraocular pressure (IOP) above 21 mmHg. Other risk factors include older age, African ancestry, family history of glaucoma, diabetes, and high myopia. Treatment aims to lower IOP through medications, laser therapy, or surgery to prevent further optic nerve damage and vision loss.
Amblyopia, commonly known as lazy eye, is a condition where vision is reduced in one or both eyes and cannot be corrected by glasses or contact lenses. It is caused by abnormal visual development during childhood. There are several types of amblyopia including stimulus deprivation, strabismic, anisometric, and isometric amblyopia. Treatment involves patching or blurring the stronger eye to encourage use of the weaker eye, along with refractive correction if needed. Therapy is most effective when started early in childhood.
1) Hypertensive retinopathy involves vasoconstrictive and vasospastic responses in the retinal arterioles that can be classified into increasing stages of severity based on observed retinal changes.
2) As hypertension progresses, it can cause narrowing and sclerosis of retinal arterioles, hemorrhages, exudates, microaneurysms, and cotton wool spots in more severe cases.
3) Evaluation of hypertensive retinopathy provides insight into the severity of hypertension and risk for end organ damage, with more advanced changes indicating poorly controlled blood pressure that threatens cardiac, cerebral and renal function.
This document provides information on evaluating and diagnosing a case of primary open-angle glaucoma (POAG). It discusses the epidemiology and risk factors of POAG such as increased age, family history, and elevated intraocular pressure. The examination involves assessing visual acuity, optic nerve head changes through fundus evaluation and imaging, visual field testing, intraocular pressure measurement, and gonioscopy to evaluate the anterior chamber angle. Diagnosis is based on characteristic optic nerve damage and visual field loss in the setting of an open anterior chamber angle and absence of other causes. Management involves long-term monitoring and treatment to lower intraocular pressure through medication or surgery as needed.
The document describes the findings of various funduscopy examinations:
1) Senile macular degeneration is described, with unusual pigmentation at the macula and drusen.
2) Central retinal vein occlusion shows an engorged, hemorrhagic appearance of the veins.
3) Hypertensive retinopathy shows narrow, tortuous arteries and advanced cases show hemorrhages and exudates with papilledema.
Low vision workup in Diabetic RetinopathyKrishna Kumar
Diabetic retinopathy is a leading cause of blindness that results from damage to the small blood vessels in the retina due to diabetes. A low vision workup for patients with diabetic retinopathy includes assessing visual acuity and performing a dilated eye exam and retinal imaging tests. Treatment depends on the severity of the retinopathy and may include laser treatment, eye injections, or surgery. Low vision aids and devices can help patients maintain independence by improving contrast and mobility.
Ocular manifestations of systemic diseasesshovon2026
This document discusses the ocular manifestations of various systemic diseases. It begins by outlining the eye examination process and then lists 11 categories of systemic diseases that can involve the eyes: 1) Connective tissue diseases like rheumatoid arthritis and lupus, 2) Spondyloarthropathies like ankylosing spondylitis, 3) Inflammatory bowel diseases, 4) Multisystem diseases like sarcoidosis and Behcet's, 5) Infectious diseases, 6) Mucocutaneous diseases, 7) Cardiovascular diseases, 8) Endocrine-metabolic diseases like diabetes, 9) Myopathies, 10) Neurologic diseases, and 11) Hematological
Management of visual problems of Aging by Ashith Tripathi Ashith Tripathi
This presentation contains headings - Visual performance in the ageing eye
Routine optometric and ocular examination of an older adult:
History
Ocular health examination
Visual acuity measurement
Refraction
Binocular vision
Visual field measurement
Colour vision
Management of vision problems in older adults
Frame requirement
Lens requirements
And special instructions etc.
The document discusses several topics related to pharmacology and aging:
- Pharmacokinetics can be altered in older adults due to reduced liver/kidney function and less efficient circulatory/nervous systems, affecting medication absorption, distribution, metabolism and excretion.
- Multiple medication use and interactions are common in older adults and can cause side effects like nausea, constipation, electrolyte imbalances if not properly monitored.
- Teaching self-administration of medications to older adults requires understanding abilities/limitations and ensuring proper understanding through questions and demonstrations.
This document summarizes various classes of anti-glaucoma medications, including their mechanisms of action and examples of drugs. It focuses on prostaglandins, describing how latanoprost, bimatoprost, and travoprost work. It also discusses adrenergic medications, carbonic anhydrase inhibitors, cholinergic drugs, and hyperosmotic agents for treating glaucoma. Side effects are provided for each class.
Glaucoma is a group of diseases that damages the optic nerve and causes vision loss and blindness. It is the second leading cause of irreversible blindness worldwide. Glaucoma has no symptoms in early stages so many people are unaware until significant vision is lost. While glaucoma cannot be cured, early detection and treatment can help control it and prevent further vision loss by lowering eye pressure through eye drops, laser treatment, or surgery. Lifelong monitoring is important since there is no cure for glaucoma.
Retinal arterial obstructions can manifest as central retinal artery obstruction (most common), branch retinal artery obstruction, or chorioretinal artery obstruction. The document discusses the history, etiology, clinical features, investigations, management, and prognosis of these conditions. Common causes include emboli (cholesterol, calcific), atherosclerosis, hypertension, and giant cell arteritis. Clinical features include sudden visual loss, afferent pupillary defect, and pale retina. Investigations include fluorescein angiography and ultrasound. Management involves ocular massage, oxygen, fibrinolytics, and treating underlying conditions. Prognosis depends on location and severity of obstruction.
Presbyopia is a natural part of the aging process where the eye's ability to focus on nearby objects decreases, requiring reading material to be held farther away. It results from a loss of accommodative amplitude and facility. Symptoms include blurred near vision, headaches, and fatigue when doing close work. Presbyopia is diagnosed through visual acuity and refraction tests and treated with reading glasses or contact lenses, and in some cases refractive surgery like monovision LASIK or lens replacement.
This document summarizes hypertensive retinopathy and its effects on the fundus. It describes the typical retinal findings seen in hypertensive patients such as arteriolar narrowing, hemorrhages, microaneurysms, cotton wool spots and exudates. It classifies retinopathy into chronic and malignant/acute forms and outlines grading scales. Treatment involves controlling blood pressure and other cardiovascular risk factors. The document cautions that rapidly worsening or malignant retinopathy requires close blood pressure management to avoid complications like stroke.
Amaurosis fugax is a transient monocular visual loss caused by thromboembolism in the internal carotid artery circulation. It is associated with vascular risk factors and the risk of stroke. Evaluation involves identifying risk factors, ophthalmological exams, and carotid imaging. Treatment focuses on controlling risk factors, antiplatelet therapy, carotid endarterectomy or stenting, and managing ocular ischemic syndrome.
The document discusses retinal vein occlusion (RVO), specifically central retinal vein occlusion (CRVO), including its demographics, pathogenesis, classification as either ischemic or non-ischemic CRVO, management through examination, investigation and treatment options, and guidelines on systemic evaluation and management. CRVO results from obstruction of venous outflow causing increased pressure and damage to retinal capillaries and is classified based on the location and extent of occlusion, with ischemic CRVO having a poorer visual prognosis without timely treatment.
Presbyopia is an age-related visual impairment caused by a gradual decrease in the eye's ability to focus on near objects. It develops as the lens inside the eye loses elasticity. There are different types and stages of presbyopia depending on the severity. Symptoms include difficulty reading small print, needing more light for near tasks, and eyestrain with close work. Presbyopia is diagnosed through patient history, visual acuity tests, and measuring the eye's remaining accommodation ability. It is typically managed through optical corrections like reading glasses, bifocal lenses, or refractive surgery options.
This document describes a case of toxoplasmosis retinochoroiditis in a 26-year-old male who presented with sudden loss of vision in his left eye. Examination found inflammation and a white lesion in the left eye along with old scarring. Tests supported a diagnosis of toxoplasmosis. The patient was treated with systemic antiparasitic medications and steroids, along with topical steroids and cycloplegics. Toxoplasmosis results from infection by the protozoan Toxoplasma gondii and commonly causes posterior uveitis, with retinitis developing near old scars when immunity is suppressed.
El documento describe un estudio sobre los factores de riesgo para la presentación tardía del glaucoma crónico en una población iraní. El estudio evaluó 312 pacientes durante 12 meses y encontró que los hombres tenían 5 veces más probabilidades de desarrollar glaucoma en etapas avanzadas que las mujeres. Además, se identificó que una presión intraocular elevada, baja educación y falta de exámenes oftalmológicos regulares aumentan el riesgo de glaucoma no detectado tempranamente.
The document discusses the results of a study on the effects of a new drug on memory and cognitive function in older adults. The double-blind study involved 100 participants aged 65-80 who were given either the drug or a placebo daily for 6 months. Researchers found that those who received the drug performed significantly better on memory and problem-solving tests at the end of the study compared to those who received the placebo.
Modern lifestyles can negatively impact fertility through factors like delayed childbearing, smoking, obesity, stress, and diet/nutrition. The document recommends several practical steps people can take to support fertility, such as not delaying childbearing past age 38, quitting smoking, losing weight if overweight, limiting caffeine/alcohol, addressing psychological stress, and following a healthy Mediterranean-style diet. The key message is that lifestyle choices have consequences for fertility and people should be aware that small adjustments could make a meaningful difference in their chances of conceiving.
Amblyopia, commonly known as lazy eye, is a condition where vision is reduced in one or both eyes and cannot be corrected by glasses or contact lenses. It is caused by abnormal visual development during childhood. There are several types of amblyopia including stimulus deprivation, strabismic, anisometric, and isometric amblyopia. Treatment involves patching or blurring the stronger eye to encourage use of the weaker eye, along with refractive correction if needed. Therapy is most effective when started early in childhood.
1) Hypertensive retinopathy involves vasoconstrictive and vasospastic responses in the retinal arterioles that can be classified into increasing stages of severity based on observed retinal changes.
2) As hypertension progresses, it can cause narrowing and sclerosis of retinal arterioles, hemorrhages, exudates, microaneurysms, and cotton wool spots in more severe cases.
3) Evaluation of hypertensive retinopathy provides insight into the severity of hypertension and risk for end organ damage, with more advanced changes indicating poorly controlled blood pressure that threatens cardiac, cerebral and renal function.
This document provides information on evaluating and diagnosing a case of primary open-angle glaucoma (POAG). It discusses the epidemiology and risk factors of POAG such as increased age, family history, and elevated intraocular pressure. The examination involves assessing visual acuity, optic nerve head changes through fundus evaluation and imaging, visual field testing, intraocular pressure measurement, and gonioscopy to evaluate the anterior chamber angle. Diagnosis is based on characteristic optic nerve damage and visual field loss in the setting of an open anterior chamber angle and absence of other causes. Management involves long-term monitoring and treatment to lower intraocular pressure through medication or surgery as needed.
The document describes the findings of various funduscopy examinations:
1) Senile macular degeneration is described, with unusual pigmentation at the macula and drusen.
2) Central retinal vein occlusion shows an engorged, hemorrhagic appearance of the veins.
3) Hypertensive retinopathy shows narrow, tortuous arteries and advanced cases show hemorrhages and exudates with papilledema.
Low vision workup in Diabetic RetinopathyKrishna Kumar
Diabetic retinopathy is a leading cause of blindness that results from damage to the small blood vessels in the retina due to diabetes. A low vision workup for patients with diabetic retinopathy includes assessing visual acuity and performing a dilated eye exam and retinal imaging tests. Treatment depends on the severity of the retinopathy and may include laser treatment, eye injections, or surgery. Low vision aids and devices can help patients maintain independence by improving contrast and mobility.
Ocular manifestations of systemic diseasesshovon2026
This document discusses the ocular manifestations of various systemic diseases. It begins by outlining the eye examination process and then lists 11 categories of systemic diseases that can involve the eyes: 1) Connective tissue diseases like rheumatoid arthritis and lupus, 2) Spondyloarthropathies like ankylosing spondylitis, 3) Inflammatory bowel diseases, 4) Multisystem diseases like sarcoidosis and Behcet's, 5) Infectious diseases, 6) Mucocutaneous diseases, 7) Cardiovascular diseases, 8) Endocrine-metabolic diseases like diabetes, 9) Myopathies, 10) Neurologic diseases, and 11) Hematological
Management of visual problems of Aging by Ashith Tripathi Ashith Tripathi
This presentation contains headings - Visual performance in the ageing eye
Routine optometric and ocular examination of an older adult:
History
Ocular health examination
Visual acuity measurement
Refraction
Binocular vision
Visual field measurement
Colour vision
Management of vision problems in older adults
Frame requirement
Lens requirements
And special instructions etc.
The document discusses several topics related to pharmacology and aging:
- Pharmacokinetics can be altered in older adults due to reduced liver/kidney function and less efficient circulatory/nervous systems, affecting medication absorption, distribution, metabolism and excretion.
- Multiple medication use and interactions are common in older adults and can cause side effects like nausea, constipation, electrolyte imbalances if not properly monitored.
- Teaching self-administration of medications to older adults requires understanding abilities/limitations and ensuring proper understanding through questions and demonstrations.
This document summarizes various classes of anti-glaucoma medications, including their mechanisms of action and examples of drugs. It focuses on prostaglandins, describing how latanoprost, bimatoprost, and travoprost work. It also discusses adrenergic medications, carbonic anhydrase inhibitors, cholinergic drugs, and hyperosmotic agents for treating glaucoma. Side effects are provided for each class.
Glaucoma is a group of diseases that damages the optic nerve and causes vision loss and blindness. It is the second leading cause of irreversible blindness worldwide. Glaucoma has no symptoms in early stages so many people are unaware until significant vision is lost. While glaucoma cannot be cured, early detection and treatment can help control it and prevent further vision loss by lowering eye pressure through eye drops, laser treatment, or surgery. Lifelong monitoring is important since there is no cure for glaucoma.
Retinal arterial obstructions can manifest as central retinal artery obstruction (most common), branch retinal artery obstruction, or chorioretinal artery obstruction. The document discusses the history, etiology, clinical features, investigations, management, and prognosis of these conditions. Common causes include emboli (cholesterol, calcific), atherosclerosis, hypertension, and giant cell arteritis. Clinical features include sudden visual loss, afferent pupillary defect, and pale retina. Investigations include fluorescein angiography and ultrasound. Management involves ocular massage, oxygen, fibrinolytics, and treating underlying conditions. Prognosis depends on location and severity of obstruction.
Presbyopia is a natural part of the aging process where the eye's ability to focus on nearby objects decreases, requiring reading material to be held farther away. It results from a loss of accommodative amplitude and facility. Symptoms include blurred near vision, headaches, and fatigue when doing close work. Presbyopia is diagnosed through visual acuity and refraction tests and treated with reading glasses or contact lenses, and in some cases refractive surgery like monovision LASIK or lens replacement.
This document summarizes hypertensive retinopathy and its effects on the fundus. It describes the typical retinal findings seen in hypertensive patients such as arteriolar narrowing, hemorrhages, microaneurysms, cotton wool spots and exudates. It classifies retinopathy into chronic and malignant/acute forms and outlines grading scales. Treatment involves controlling blood pressure and other cardiovascular risk factors. The document cautions that rapidly worsening or malignant retinopathy requires close blood pressure management to avoid complications like stroke.
Amaurosis fugax is a transient monocular visual loss caused by thromboembolism in the internal carotid artery circulation. It is associated with vascular risk factors and the risk of stroke. Evaluation involves identifying risk factors, ophthalmological exams, and carotid imaging. Treatment focuses on controlling risk factors, antiplatelet therapy, carotid endarterectomy or stenting, and managing ocular ischemic syndrome.
The document discusses retinal vein occlusion (RVO), specifically central retinal vein occlusion (CRVO), including its demographics, pathogenesis, classification as either ischemic or non-ischemic CRVO, management through examination, investigation and treatment options, and guidelines on systemic evaluation and management. CRVO results from obstruction of venous outflow causing increased pressure and damage to retinal capillaries and is classified based on the location and extent of occlusion, with ischemic CRVO having a poorer visual prognosis without timely treatment.
Presbyopia is an age-related visual impairment caused by a gradual decrease in the eye's ability to focus on near objects. It develops as the lens inside the eye loses elasticity. There are different types and stages of presbyopia depending on the severity. Symptoms include difficulty reading small print, needing more light for near tasks, and eyestrain with close work. Presbyopia is diagnosed through patient history, visual acuity tests, and measuring the eye's remaining accommodation ability. It is typically managed through optical corrections like reading glasses, bifocal lenses, or refractive surgery options.
This document describes a case of toxoplasmosis retinochoroiditis in a 26-year-old male who presented with sudden loss of vision in his left eye. Examination found inflammation and a white lesion in the left eye along with old scarring. Tests supported a diagnosis of toxoplasmosis. The patient was treated with systemic antiparasitic medications and steroids, along with topical steroids and cycloplegics. Toxoplasmosis results from infection by the protozoan Toxoplasma gondii and commonly causes posterior uveitis, with retinitis developing near old scars when immunity is suppressed.
El documento describe un estudio sobre los factores de riesgo para la presentación tardía del glaucoma crónico en una población iraní. El estudio evaluó 312 pacientes durante 12 meses y encontró que los hombres tenían 5 veces más probabilidades de desarrollar glaucoma en etapas avanzadas que las mujeres. Además, se identificó que una presión intraocular elevada, baja educación y falta de exámenes oftalmológicos regulares aumentan el riesgo de glaucoma no detectado tempranamente.
The document discusses the results of a study on the effects of a new drug on memory and cognitive function in older adults. The double-blind study involved 100 participants aged 65-80 who were given either the drug or a placebo daily for 6 months. Researchers found that those who received the drug performed significantly better on memory and problem-solving tests at the end of the study compared to those who received the placebo.
Modern lifestyles can negatively impact fertility through factors like delayed childbearing, smoking, obesity, stress, and diet/nutrition. The document recommends several practical steps people can take to support fertility, such as not delaying childbearing past age 38, quitting smoking, losing weight if overweight, limiting caffeine/alcohol, addressing psychological stress, and following a healthy Mediterranean-style diet. The key message is that lifestyle choices have consequences for fertility and people should be aware that small adjustments could make a meaningful difference in their chances of conceiving.
The document discusses lifestyle factors that can impact fertility, including delaying childbearing, smoking, obesity, stress, and diet. It provides recommendations for improving fertility by not delaying treatment, quitting smoking, losing weight if obese, limiting stress, and eating a healthy diet. The document also discusses vitamins and foods that can support fertility, like lentils, garlic, honey, olive oil, and a Mediterranean-style diet.
This document discusses modern lifestyle trends and their impact on infertility. It notes that delaying childbearing and fertility treatment, smoking, obesity, stress, and certain environmental toxins can negatively influence fertility. Certain foods (like lentils, garlic, honey), a Mediterranean diet, olive oil, and vitamins may help fertility. The document provides recommendations around lifestyle changes like not delaying childbearing or IVF past age 38, limiting but not eliminating caffeine and alcohol, and quitting smoking to improve fertility outcomes. It emphasizes the importance of lifestyle choices in both reducing infertility and improving the success of fertility treatments.
Gran parte delle patologie e dell’invecchiamento degli esseri viventi sono causati da processi chimici ossidativi generati da produzione eccessiva di radicali liberi. La presentazione mostra nello specifico l'impatto dello stress ossidativo sulla riproduzione.
PER AVER SUCCESSO NEL RECUPERO DELLA FERTILITA’ MASCHILE E’ NECESSARIO INTERVENIRE SUI FATTORI DI RISCHIO
PER TUTELARE LA FERTILITA’ DEL NASCITURO E’ NECESSARIO INTERVENIRE SULLO STILE DI VITA DEI GENITORI - L’INFERTILITA’ MASCHILE E’ TRASMISSIBILE DA GENITORE A FIGLIO E FRA CIO’ CHE VIENE TRASMESSO ANCHE L’INADEGUATO STILE DI VITA
IL MONDO NON LO DOBBIAMO CONSIDERARE UN BENE CHE CI E’ STATO OFFERTO MA UN DONO DA LASCIARE AI NOSTRI FIGLI! mf
INFERTILITA': SESSUALITA' , ALIMENTAZIONE, STILI DI VITA, NUTRIZIONE E MICRONUTRIZIONE. "Le Scienze ANDROLOGICHE INTEGRATE" - Dr. Marco FIRMO Medico Chirurgo, Specialista in Andrologia e Medicina Metabolica Funzionale.
Approccio Andrologico alla coppia Infertile in un Centro DyD P.N.A CHE COS’E’ LA PNA PROCREAZIONE NATURALMENTE ASSISTITA OTTENERE FECONDAZIONE, CRESCITA, SVILUPPO DELL’EMBRIONE, E LA NASCITA RECUPERANDO E/O OTTIMIZZANDO LE SINGOLE CAPACITA’ PROCREATIVE MASCHILI E FEMMINILI, ATTRAVERSO UN APPROCCIO MEDICO SECONDO I DETTAMI DELLA MEDICINA REGOLATORIA FUNZIONALE m.f.
1. “Società dell’immagine:
il mito della virilità e della femminilità”
Nutraceutica e Infertilità
Andria 12 maggio 2012
2. INFERILITA’ MASCHILE
Diversi studi hanno dimostrato un costante declino della qualità e
della quantità del liquido seminale nei maschi che vivono in
Paesi industrializzati e con stile di vita occidentalizzanti.
Un fenomeno di popolazione prima ancora che individuale e/o di
coppia.
5. Anche le patologie ginecologiche spesso sono
cause indirette di alterazione del liquido
seminale:
I partner delle donne affette da
queste patologie, sono adusi ad
una maggiore continenza sessuale
ed eiaculatoria, ciò comporta un
ridotto turnover nemaspermico ed
• PELVIDINIA un aumento dei processi apoptotici
lungo le vie seminali.
• ENDOMETRIOSI
6. L’ossigeno amico e nemico:
paradosso della respirazione cellulare aerobica: O 2
• essenziale per la produzione di energia
• citotossico per la produzione di ROS
7. • La produzione di ROS è correlata alla quantità di O2 utilizzato per la produzione di energia a livello di cellule e tessuti ( es:apparato muscolare,
cardiaco e visceri interni)
• I tessuti sono dotati di un sistema di neutralizzazione di ROS: BARRIERA ANTIOSSIDANTE
• il rapporto tra produzione di ROS e capacità del sistema di neutralizzarli costituisce la TAC: capacità antiossidante totale
8. Enzimi scavengers:
( utlili barriere contro il danno ossidativo.Sono enzimi atti all’arresto della
cascata di reazioni dei radicali)
Intracellulari: Extracellulari:
• Superossidodismutasi • Superossido-Dismutasi
• Glutatione-Perossidasi • Ac. Citrico
• Catalasi • Ac. Ascorbico
• Taurina/Ipotaurina
9. In condizioni fisiologiche lo spermatozoo produce piccole
quantità di specie reattive dell’ossigeno (ROS)
necessarie per la capacitazione, reazione acrosomiale e
fertilizzazione ovocitaria .
ROS TAC
▲
10. STRESS OSSIDATIVO
Determinato da una modificazione dell’equilibrio
intracellulare tra sostanze ossidanti prodotte
fisiologicamente durante i processi metabolici e il
sistema di difesa antiossidante che svolge la funzione di
bilanciare tali specie reattive
ROS______________________ TAC
▲
11. STRESS OSSIDATIVO
Se la bilancia ossidativa si altera si determina una condizione di
insulto
Lo squilibrio della bilancia ossidativa è causa frequente di
infertilità maschile
TAC
▲
ROS
I RADICALI LIBERI INDUCONO DANNO OSSIDATIVO AGLI SPERMATOZOI
12. Spermatozoi e
leucociti sono grandi
utilizzatori di O2 e
forti produttori di
ROS
Lo stress ossidativo
causa:
•ridotta mobilità
•ridotta capacità di
fertilizzazione
•alterazioni del DNA
13. ALTERAZIONI STRUTTURALI
• I ROS perossidano gli acidi grassi polinsaturi (PUFA) della
membrana plasmatica dello spermatozoo così la membrana
diventa più rigida causando una riduzione della flessibilità
caudale e quindi della capacità natatoria
14. ALTERAZIONI ENERGETICHE
• Ridotta produzione di ATP ( intesa come incapacità di
sintetizzare o incapacità di utilizzare l’ATP ) da parte
dell’apparato mitocondriale a causa di una ridotta
concentrazione di scavengers e carnitina
15. ALTERAZIONI GENOMICHE
I ROS si legano ai nucleotidi del DNA alterandone la conformazione e la
trascrizione .
I ROS si legano direttamente alle eliche del DNA, rendendole instabili e
generando delle rotture e mutazioni. Ciò porta ad una ridotta
capacità fecondante dell’uomo, aborti precoci o mutazioni genetiche
dell’embrione.
16. EFFETTI SUL PLASMA SEMINALE
• Si osservano alterazioni della viscosità, densità e osmolarità del
plasma seminale con alterazione della capacità natatoria, in quanto
lo spermatozoo rimane intrappolato in sacche di sostanze mucoidi .
18. COME MIGLIORARE LA FERTILITA’ NEL MASCHIO
1) Rimuovere i fattori di rischio
2) Aumento dell’introito alimentare di sostanze antiossidanti e
somministrazione di supplementi esogeni
19. Nutraceutica
"nutrizione" e "farmaceutica"
È un termine coniato dal Dr. Stephen De Felice nel 1989 e si intende lo
studio delle proprietà combinate nutritive e farmaceutiche degli
alimenti che hanno una funzione benefica sulla salute umana
20. Nutraceutica e Sostanze ad aumentata capacità
antiossidante
1.Vitamine antiossidanti (C,E) coinvolte nella fertilità
2.Coenzimi ed elementi traccia (Ubichinone o coenzima Q10, acido
folico, selenio, zinco) coinvolti nella rimozione enzimatica dei ROS
3.Sostanze coinvolte nella produzione di energia: come substrato
(fruttosio) o carrier (carnitine)
4.Supplementi multicomponenti (miscele di sostanze antiossidanti ed
esogene) capaci di intervenire nei vari step del metabolismo energetico
21. Obiettivo finale sullo spermatozoo
1. Ripristinare una corretta produzione di energia
2. Rimettere in equilibrio la bilancia ossidativa
1. Favorire la produzione di spermatozoi maturi
22. Coenzima Q10
•Componente della catena respiratoria mitocondriale per la produzione
di ATP
•Antiossidante perché protegge la membrana mitocondriale dall’azione
perossidante dei ROS
•C’è correlazione positiva tra concentrazione di Q10 nel plasma seminale
e nello spermatozoo e concentrazione e mobilità degli spermatozoi
23. Correlazione tra valori seminali
del coenzima e conta degli
spermatozoi in maschi sani o
con varicocele.
24. Vitamina C/E
•C è il maggior antiossidente cellulare ( neutralizza direttamente i ROS
prevenendo i fenomeni di agglutinazione degli spermatozoi e quindi
favorendo la fertilità)
•C è coinvolto nella rigenerazione di E
•E si trova sulla membrana mitocondriale ed è coinvolta nella rimozione
dei ROS prodotti durante la sintesi dell’ATP
26. Zinco
Potente antiossidante e Cofattore di numerosi coenzimi della bilancia ossidativa
Concentrazioni adeguate di questo metallo sono necessarie alla sintesi e alla trascrizione del
DNA, per l’espressione di alcuni recettori degli ormoni steroidei e per la stabilità della
membrana cellulare
TESTICOLO SPERMATOZOO
STEROIDOGENESI CONSUMO DI O2
SVILUPPO TESTICOLARE CONDENSAZIONE DELLA CROMATINA
NELL’ADOLOSCENZA
SINTESI TESTOSTERONE REAZIONE ACROSOMIALE
CONVERSIONE DI TESTOSTERONE A 5 MORFOLOGIA E MOTILITA’
–α-DIIDROTESTOSTERONE
27. Effetti della supplementazione di Zn sulla fertilità e sulla maturazione
sessuale
SPERMATOZOO ALTRI
AUMENTA DENSITA’ E MOTILITA’ ACCELERA COMPARSA DEI
CARATTERI SESSUALI
MIGLIORA MORFOLOGIA INCREMENTA CONCENTRAZIONE
DI TESTOSTERONE
28. e
Acido folico e vitamine del gruppo B
La carenza dietetica di folati e vitamine del gruppo B è responsabile
di iperomocisteinemia responsabile di aumento dello stress
ossidativo a livello testicolare e ad alterazione dello spermiogramma,
quindi a infertilità.
29. Sostanze pro-energetiche
Lo spermatozoo nella sua breve vita ( 24-72 ore) da quando lascia l’epididimo
(immobile) ed è espulso in vagina, è condannato ad un movimento senza sosta e a
grande velocità.
Le molecole coinvolte in questa fase da cui deriva l’energia, sono fruttosio, glucosio in
minor quantità e il sistema delle carnitine
30. Licopene
•Presente nel plasma umano in concentrazioni maggiori rispetto
al β – Carotene ed altri carotenoidi
•Migliora la concentrazione, la motilità e la morfologia degli
spermatozoi.
•La sua azione antiossidante può essere potenziata dalla
concomitante presenza di flavonoidi.
31. • L’obiettivo finale è quello di migliorare le qualità e le quantità del liquido
seminale e ciò è possibile seguendo una terapia adeguata composta da
diversi antiossidanti spesso associate in specifiche formulazioni
farmaceutiche, sotto forma di integratori alimentari.
• Gli integratori alimentari sono facili da reperire, hanno un costo moderato e
sono facili da assumere.
• Presentano un’alta digeribilità e ipoallergenicità.
• Inoltre l’alimentazione gioca un ruolo predominante nel combattere lo stress
ossidativo;basti considerare gli alimenti che compongono la dieta
mediterranea , ricchi di vitamina C, Zn , Carotenoidi e Licopene .