Kellner Ulrich, Kellner Simone, Weinitz Silke, Farmand Ghazaleh
Klin Monbl Augenheilkd. 2022 Dec;239(12):1493-1511. doi: 10.1055/a-1961-8166. Epub 2022 Nov 17.
Exogenously induced retinopathies can be caused by consumation of stimulating substances, systemic or ocular medications, vaccinations, light or irradiation. Some of the effects are transient, whereas other effects induce irreversible toxic reactions. Retinal damage may develop either acutely with obvious relation to the damaging cause, but often may take a long duration of repeated use of a substance or medication. External stimulants (e.g. nicotine, alcohol, poppers, methanol) are the most frequent cause of exogenously induced retinal damage. Side effects from systemic drugs (e.g. hydroxychloroquine, ethambutol, MEK-, ERK-, FLT3-, checkpoint inhibitors, didanosin, pentosanpolysulfat sodium) or intravitreally applied drugs (e.g. antibiotics, VEGF-inhibitors) are less frequent. Ocular side effects associated with vaccinations are rare. Ambient light sources induce no damaging effects on the retina. Incorrect use of technical or medical light sources (e.g. laser pointers) without adherence to safety recommendations or unshielded observation of the sun might induce permanent retinal damage. Local or external irradiation might induce retinal vascular damage resulting in radiation retinopathy.
外源性诱导的视网膜病变可由刺激性物质的摄入、全身或眼部药物、疫苗接种、光线或辐射引起。其中一些影响是短暂的,而其他影响则会引发不可逆的毒性反应。视网膜损伤可能与损伤原因有明显关联而急性发生,但通常可能在长期反复使用某种物质或药物后才出现。外部刺激物(如尼古丁、酒精、亚硝酸异戊酯、甲醇)是外源性诱导视网膜损伤最常见的原因。全身药物(如羟氯喹、乙胺丁醇、MEK-、ERK-、FLT3-、检查点抑制剂、去羟肌苷、戊聚糖多硫酸钠)或玻璃体内应用药物(如抗生素、血管内皮生长因子抑制剂)的副作用则较少见。与疫苗接种相关的眼部副作用很罕见。环境光源不会对视网膜造成损伤。不遵守安全建议不正确使用技术或医疗光源(如激光笔)或无防护地直视太阳可能会导致永久性视网膜损伤。局部或外部辐射可能会导致视网膜血管损伤,从而引发放射性视网膜病变。