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Anti Aging Oral Boards > Ophthalmology > Flashcards

Ophthalmology Flashcards

1
Q

What are the risk factors for developing cataracts?

A 
UV radiation
Diabetes
Topical or systemic steroids
Smoking 
Poor nutrition
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2
Q

What is glycation?

A

The binding of glucose to proteins which results in free radical production

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3
Q

Diabetes increases what enzyme that eventually leads to the production of cataracts?

A

Aldose reductase

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4
Q

What is aldose reductase?

A

It is an enzyme that catalyze one of the steps in the polyol (a sugar alcohol) pathway that is responsible for the formation of fructose from glucose

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5
Q

How does diabetes lead to cataracts?

A

Aldose reductase levels increase with an increase in glucose in tissues that are not insulin sensitive, including the lens, peripheral nerves and glomeruli. Aldose reductase reduces glucose to its alcohol. The lens is relatively impermeable to sugar alcohols. The lens imbibes water, causing an osmotic imbalance. Eventually, increased sodium and decrease potassium levels and decreased final levels lead to cataract formation.

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6
Q

What flavonoid can slow the progression of diabetes-related cataracts?

A

Quercetin. It can inhibit aldos reductase

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7
Q

Cataract symptoms

A

Altered color vision
Fells like you are looking through a piece of clouded glass
Increased sensitivity to bright lights
Increased blurred vision
Need brighter illumination (trouble seeing in the dark)
Diplopia when looking out of one eye
Vision that is brighter in one eye than the other

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8
Q

Nutrients that are protective against cataracts

A 
Carnosine
Glutathione
Taurine
Cysteine
Vitamins A, C & E (antioxidants)
Vitamin B2
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9
Q

Carnosine is formed by the combination of what 2 amino acids?

A

Beta alanine

Histidine

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10
Q

How does carnosine protect against cataract formation?

A

It is an antioxidant
It binds metal ions that cause tissue damage
It blocks the aging effects of glycation by competing with proteins for the binding sites they would occupy on sugar molecules

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11
Q

How does carnosine protect against dementia?

A

It inhibits beta amyloid toxicity

It chelates copper and zinc

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12
Q

What is the oral dose of carnosine?

A

1000-2000 mg per day

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13
Q

Use caution of supplementing carnosine in what medical conditions?

A

Liver or kidney disease

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14
Q

Carnosine used as eye drops has what effect on DNA?

A

It prevents DNA strand breaks induced by UV radiation

It enhances DNA repair

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15
Q

Treatment for dry eyes

A

Eye drops

EPA and DHA

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16
Q

Diseases that carnosine is used to treat

A 
Alzheimer's
Aging
Atherosclerosis
Brain injury
Cataracts
Diabetes
HTN
Stroke
Wound healing
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17
Q

What AAs is glutathione made of?

A

Glycine
Glutamic acid
Cysteine

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18
Q

How does glutathione protect against cataracts?

A

It functions to protect the structural proteins and enzymes needed for the maintenance of lens flexibility and clarity against free radical production

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19
Q

Loss of glutathione in the eye leads to what?

A

Glycation and thus cataracts

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20
Q

At what age does glutathione production in the body start to decrease?

A

40

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21
Q

Why can’t glutathione be taken by mouth?

A

Digestive enzymes break it down. It can be take as NAC

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22
Q

What are the nutrients that can increase glutathione?

A 
Vitamin C
ALA
Glutamine
Methionine
SAMe
Whey protein
Vitamin E
Milk thistle
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23
Q

What can decrease glutathione

A

Cigarette smoking
Processed meats containing nitrites or nitrates
Excessive EtOH
Acetaminophen

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24
Q

Food sources of glutathione

A 
Asparagus
Avocado
Walnuts
Fish
Meat
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25
Q

What is the typical dose range for NAC?

A

500 - 3000 mg per day

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26
Q

Why should NAC be given with vitamin C?

A

To prevent kidney stone formation

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27
Q

If taking NAC for a long duration, what should be supplemented

A

Zinc and copper. NAC can bind them

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28
Q

How does glutathione affect the immune system?

A

It stimulates IL-1 and IL-2 production

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29
Q

What vitamins does glutathione help to recycle?

A

Vitamins C and E

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30
Q

How can glutathione help with weight loss?

A

It decreases sugar cravings

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31
Q

What does glutathione do in the liver?

A

It helps with detoxification of chemicals and heavy metals

32
Q

How does glutathione help with cancer?

A

It is involved with DNA synthesis and repair

33
Q

High concentrations of what amino acid are needed by the eye to maintain optimal function and structure?

A

Taurine

34
Q

Taurine needs what to help it function properly?

A

Zinc

35
Q

Taurine helps protect the lens of the eye from what?

A

Free radical damage

36
Q

Taurine is made of what?

A

Methionine and cysteine

37
Q

What can deplete the body of taurine?

A

Stress

38
Q

What are the cardiac effects of taurine?

A 
Lowers blood pressure
Strengthens cardiac muscle
Stabilizes heart rhythm
Prevents blood clots
Is a natural diuretic
39
Q

What are the metabolic effects of taurine?

A

Increases insulin receptor activity

Improves fat metabolism in the liver

40
Q

What organs systems benefit from taurine?

A

Lung and kidney

Also the gallbladder (needed for the formation of bile acids)

41
Q

How does taurine function as an inhibitory neurotransmitter?

A

It stabilizes membranes by modulating calcium movement

42
Q

What are natural sources of taurine?

A 
Brewer's yeast
Dairy
Eggs
Fish
Meat
Other seafood
43
Q

What is a typical dose for taurine?

A

1 to 4 grams per day. The dose requirement increases when you are ill

44
Q

You may have a block in the pathway that produces taurine if what lab value is elevated?

A

Homocysteine

45
Q

Use caution in taking taurine if you have what medical condition?

A

Renal disease. AAs are cleared through the kidney

46
Q

How does vitamin C protect the eye?

A

It protects against UV radiation and thus reduces cataracts

47
Q

How does riboflavin (B2) protect the lens and thus prevent cataracts?

A

It removes oxidized glutathione from the lens

48
Q

How is vitamin A beneficial for the eye?

A

It is important for retinal function. Retinal combines with ops in to form rhodopsin which is necessary for both low-light and color vision. It also protects against cataracts.

49
Q

What do studies about cataracts and vitamin E show?

A

That supplementing with vitamin E with vitamin C will slow the progression of cataracts by 60% over 10 years

50
Q

What is the leading cause of blindness after age 55?

A

Macular degeneration

51
Q

What causes macular degeneration?

A

Unknown, but the theory is oxidative damage and poor circulation. It does run in families.

52
Q

Macular degeneration affects more people than what 2 ophthalmologist diseases combined?

A

Cataracts and glaucoma

53
Q

What is the epidemiology of macular degeneration in regards to sex and race?

A

Equal in men and women. More common in whites compared to blacks

54
Q

What are the 2 types of macular degeneration?

A

Dry (85-90%) and wet. It can affect both eyes simultaneously.

55
Q

What are the symptoms of macular degeneration?

A

Normally straight objects will appear bent or wavy
A dark or blurry spot will appear in the center of your vision
When you cover up one eye, whatever you are looking at changes size or color

56
Q

What are the risk factors for macular degeneration?

A 
Age > 55
Hazel/blue/green eyes
Smoking
Frequent sunlight exposure without UV blockers
Postmenopausal women
57
Q

Studies show that eating dark leafy vegetables is associated with what percent decreased risk for macular degeneration?

A

43%

58
Q

What are the 2 carotenoids in the yellow layer of nerves that links the retina to the optic nerve?

A

Lutein

Zeaxanthin

59
Q

What vegetables have large amounts of lutein and zeaxanthin?

A 
Spinach
Mustard greens
Kale
Broccoli
Parsley 
Celery
Green peas
Brussels sprouts
Pumpkin
Squash
Carrots
Yams
Corn
Green beans
(Also in eggs)
60
Q

Taking extra vitamin C helps with what form of macular degeneration?

A

Dry macular degeneration. It helps prevent broken blood vessels and new blood vessel growth over the macula

61
Q

What are bioflavonoids?

A

A group of compounds that are found primarily in fruit

62
Q

What fruit are bioflavonoids found in?

A 
Berries
Lemons
Grapefruit
Grapes
Black currants
Cherries
Plums 
Apricots
63
Q

How are bioflavonoids beneficial for the skin?

A

They assist in maintaining collagen which strengthened connective tissue

64
Q

What interaction do bioflavonoids have with vitamin C?

A

They enhance the absorption of vitamin C

65
Q

What supplements are bioflavonoids found in?

A 
Quercetin
Ginkgo biloba 
Bilberry extract
Grape seed extract
Cranberry extract
66
Q

How is bilberry beneficial for vision

A

It specifically goes to the eyes and improves night vision

67
Q

What are the 4 types of glaucoma

A

Simple or open angle
Narrow or closed angle
Low pressure (circulatory)
Toxic

68
Q

What causes open angle glaucoma

A

The fluid drain is open but partially blocked.

69
Q

What are the risk factors for simple/open angle glaucoma?

A 
Arteriosclerosis
HTN
DM
Smoking
EtOH abuse
Black
History of severe anemia or shock
70
Q

What are the causes of narrow angle glaucoma?

A

Steroids (depletes vitamin C and increases intraocular pressure)
Allergies (antihistamines can cause the pupil to dilate)
Genetics
Age
Female
Nearsightedness
Asian, hispanic, black

71
Q

What causes Low pressure glaucoma (circulatory)?

A

Poor circulation to the eyes. Optic nerve cells die due to lack of nutrients

72
Q

What are the etiologies of low pressure glaucoma?

A

Cardiac disease
Contriction of blood vessels
Elevated cholesterol
Imbalance of calcium and magnesium

73
Q

What causes toxic glaucoma?

A

Cigarette smoke
MSG
Aspartame

74
Q

What is the treatment for glaucoma?

A

Eye drops to lower the pressure
Hyperbaric oxygen
Antioxidants

75
Q

Treatment for dry eyes

A

Drops containing antioxidants and carnosine

EPA and DHA

Anti Aging Oral Boards (5 decks)

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