E kamaʻilio kākou e pili ana i ka Birdshot Chorioretinopathy i kēia lā?

Ua manaʻo paha ʻoe e like me ka ʻike ʻana i nā mea ʻeleʻele liʻiliʻi e lana ana i mua o kou mau maka? A i ʻole he ʻano pōwehiwehi iki paha kou ʻike? He mea maʻamau kēia mau mea, akā i kekahi manawa he hōʻailona ia o kahi pilikia i loko o kou maka. I kēia lā e kamaʻilio mākou e pili ana i kekahi ʻano maʻi maka kakaʻikahi hiki ke hoʻomalu ʻia inā mālama pono ʻia.

He aha kēia (Birdshot Chorioretinopathy)?

I ka ʻōlelo maʻalahi, ʻo Birdshot Chorioretinopathy, a i ʻole BSCR no ka pōkole, he maʻi mumū laha ʻole ia e kū ana i loko o ka maka. ʻAʻole ia he maʻi mau loa , ʻo ia hoʻi, ʻaʻole ia e hoʻomaikaʻi i loko o kahi manawa pōkole, akā he maʻi mau. Inā ʻaʻole mālama pono ʻia, hiki iā ia ke alakaʻi i nā loli mau loa o ka ʻike a i ʻole ka nalowale loa o ka ʻike .

(BSCR) he maʻi koʻikoʻi ia no kahi hui o nā maʻi i kapa ʻia ʻo "Uveitis", e hōʻino ana i nā ʻiʻo i loko o ka maka. ʻO ia hoʻi ka pehu ʻana o:

• Retina : ʻO kēia ka membrane ʻike mālamalama ma ke kua o ko kākou maka. Ua like ia me ke kiʻiʻoniʻoni i loko o ke kāmela. Hoʻopaʻa ʻia nā kiʻi a kākou e ʻike ai ma ʻaneʻi.
• ʻO Choroid : Aia kēia ma lalo o ka retina. ʻO kēia ka membrane e hoʻopili ai i ka retina i ka ʻāpana keʻokeʻo o ka maka, a hoʻolako i ke koko i ka retina, ʻo ia hoʻi, hānai iā ia.

ʻO ka hiʻohiʻona ʻano nui o kēia maʻi, ʻo ia ke ʻano o nā kiko liʻiliʻi, oval, a me ka ʻulaʻula ma ka ʻaoʻao hohonu o ka retina a me ka papa luna o ka choroid. ʻO nā hōʻailona mua e komo pinepine i nā mea ʻeleʻele e lana ana i mua o nā maka (floaters) , ka ʻike maka pōwehiwehi , a i ʻole nā ​​mea ʻelua. Hoʻopilikia pinepine kēia ʻano i nā maka ʻelua .

I ka hala ʻana o ka manawa, hiki i kēia hōʻino ke alakaʻi i nā kūlana e like me ka cystoid macular edema a i ʻole glaucoma . ʻOiai ʻaʻohe lāʻau lapaʻau, he maʻi hiki ke mālama ʻia ka Birdshot Chorioretinopathy. He mea nui ka ʻike mua ʻana no ka mālama pono ʻana.

ʻO wai ka mea e loaʻa ana i ka Birdshot Chorioretinopathy?

ʻOiaʻiʻo, hiki i kēia maʻi ke ulu i loko o kekahi. Akā, ʻoi aku ka maʻamau i nā pākeke keʻokeʻo waena ma waena o 40 a me 60 mau makahiki. He mea kākaʻikahi loa i nā keiki ke loaʻa i kēia maʻi.

Aia kekahi mau maʻi ʻē aʻe e like me kēia (Birdshot Chorioretinopathy)?

ʻAe, hiki i kekahi mau maʻi ʻē aʻe, me nā maʻi ʻē aʻe i ka hui Uveitis, ke loaʻa nā hōʻailona like me Birdshot Chorioretinopathy. No laila, he mea nui loa ka loaʻa ʻana o kahi hōʻailona pololei i hiki iā ʻoe ke loaʻa ka lāʻau kūpono. ʻO kekahi o nā maʻi e like me BSCR:

• ʻO Lymphoma (kahi ʻano maʻi kanesa)
• ʻO Sarcoidosis (kahi maʻi e hoʻoulu ai i nā pehu liʻiliʻi ma nā ʻāpana like ʻole o ke kino)
• `(Sympathetic ophthalmia)` (He ʻano uveitis kakaikahi i hoʻokumu ʻia e ka ʻeha maka)
• ʻO Syphilis (kahi maʻi i laha ma ke ʻano moekolohe)
• `(Manaʻo ʻia he maʻi histoplasmosis ocular (POHS))` (He kūlana e hoʻopilikia ana i nā maka i hoʻokumu ʻia e kahi maʻi fungal)
• `(Maʻi ʻōpū)` (Maʻi ʻōpū)
• `(Vogt-Koyanagi-Harada syndrome)` (kahi maʻi e hoʻopilikia ai i ka ʻōnaehana nerve, e hoʻopilikia ana i ka ʻike a me ka lohe)

Aia kekahi hui o nā maʻi mumū i kapa ʻia ʻo "White dot syndromes", hiki ke hōʻike i nā hōʻailona o BSCR. Hoʻoulu kēia i nā "lei" i ka retina a me ka choroid. ʻO kekahi mau laʻana:

• ʻO ka epitheliopathie pigment placoid multifocal posterior acute (APMPPE)
• `(Multifocal choroiditis a me ka panuveitis (MCP))`
• `(ʻO ka maʻi kiko keʻokeʻo evanescent he nui (MEWDS))`
• `(Punctate inner choroidopathy (PIC))`

No ke aha i kapa ʻia ai kēia (Birdshot Chorioretinopathy)?

He maʻi hou kēia, i wehewehe mua ʻia i ka makahiki 1949. ʻAʻole a hiki i ka makahiki 1980 i hāʻawi ai ʻelua mau kauka maka i ka inoa "(Birdshot Chorioretinopathy)". ʻO ke kumu, aia nā kiko oval kirīmi a me ka ʻalani i hoʻopuehu ʻia ma loko o ka retina. Loaʻa ka inoa mai ka ʻoiaʻiʻo ua like ke ʻano o kēia mau kiko me ke ʻano o nā pōkā liʻiliʻi (birdshot) i hoʻohana ʻia e pana i nā manu. E noʻonoʻo, aia nā kiko i loko o ka maka, e like me nā pōkā i hoʻopuehu ʻia i ka wā e puhi ʻia ai ka pū.

Aia kekahi mau inoa ʻē aʻe no kēia?

ʻAe, aia kekahi mau inoa ʻē aʻe i hoʻohana ʻia no ka maʻi (Birdshot Chorioretinopathy):

• ʻO ke chorioretinitis o ka manu
• `(Birdshot retinochoroiditis)`
• `(Birdshot retinochoroidopathy)`
• `(Uveitis manu)`
• `(BSCR)` (inoa pōkole)
• ʻO ka uveitis hope loa (uveitis e kū mai ana ma hope o ka maka)
• `(Vitiliginous choroiditis)`

Pehea ka maʻamau o ka Birdshot Chorioretinopathy?

He maʻi laha ʻole kēia. Manaʻo nā kānaka noiʻi ʻaʻole ia e pili ana i hoʻokahi i loko o hoʻokahi haneli tausani kānaka. ʻO ke ʻano kēia, aia paha ma Sri Lanka, aia paha ka poʻe me kēia maʻi, akā he kakaikahi loa ka helu.

He aha ke kumu o ka Birdshot Chorioretinopathy?

ʻAʻole ʻike maopopo nā kānaka noiʻi i ke kumu kikoʻī o ka maʻi, akā ke manaʻo nei lākou he maʻi autoimmune ia. I ka ʻōlelo maʻalahi, hoʻouka hewa ka ʻōnaehana pale ponoʻī o ko mākou kino, ʻo ia hoʻi ka ʻōnaehana pale maʻi, i ko mākou mau ʻiʻo olakino ponoʻī.

ʻOi aku ma mua o 90% o ka poʻe i ʻike ʻia me (BSCR) he gene antibody (kahi mole e hoʻoulu ai i ka ʻōnaehana pale) i kapa ʻia ʻo `(HLA-A29)` i loko o ko lākou kino. He mea kēia i hoʻoilina ʻia mai nā mākua mai. Eia nō naʻe, ʻaʻole pono ka `(HLA-A29)` e ulu ai (Birdshot Chorioretinopathy). Eia kekahi, hiki ke loaʻa kēia gene antibody akā ʻaʻole e ulu ka maʻi.

He aha nā hōʻailona o ka Birdshot Chorioretinopathy?

Hiki ke ʻokoʻa nā hōʻailona o kēia maʻi mai kēlā kanaka a kēia kanaka.ʻO ka maʻi e holomua nei, ʻo ia ka maʻi e lilo mālie ana i mea ʻino ma loko o kekahi mau mahina a i nā makahiki.

ʻO nā hōʻailona mua o ka Birdshot Chorioretinopathy pinepine:

• ʻIke ʻana i nā mea ʻeleʻele e lana ana i mua o nā maka (floaters)
• ʻIke pōwehiwehi

ʻAʻole maʻamau kēia ʻano e hōʻeha ai i ka maka a i ʻole ka ʻulaʻula . Eia nō naʻe, hiki iā ʻoe ke ʻike i kēia mau mea:

• Nā loli o ka ʻike a i ʻole ka emi ʻana o ka ʻike.
• Ka emi ʻana o ka ʻike peripheral a i ʻole ka paʻakikī i ka hoʻoholo ʻana i ka mamao.
• Ke kaomi kiʻekiʻe i loko o ka maka (ocular hypertension).
• Makapō pō (nyctalopia) (ʻike maikaʻi ʻole i ka pō).
• Nā pilikia ʻike kala (`(makapō kala)`), paʻakikī ke hoʻokaʻawale i kekahi mau kala (`(dychromatopsia)`.
• ʻIke i ka mālamalama ʻālohilohi a i ʻole ka glare (photophobia).

Hiki i kekahi poʻe ke loaʻa nā loli ʻike maka ʻē aʻe a i ʻole nā ​​pilikia noʻonoʻo. Eia kekahi laʻana:

• Ka hopena o ka peʻahi kaupaku : Ke pani ʻoe i kou mau maka, me he mea lā e wili ana kahi peʻahi kaupaku a i ʻole ka wili makani.
• ʻIke ʻana i nā kukui ʻālohilohi a i ʻole ka ʻālohilohi (photopsia) a i ʻole ka ʻike ʻana i nā kinona i hoʻopāpā ʻia (metamorphopsia) .
• ʻIke pōwehiwehi a ʻālohilohi, me he mea lā e nānā ana ma o ka wai a i ʻole ke aniani lepo .

I nā hihia koʻikoʻi, hiki ke ulu nā kūlana e like me ka cataracts a i ʻole glaucoma. Hiki i kēia mau mea ke hōʻeha nui i ka ʻike ʻoiai ma hope o ka mālama ʻana no ka pehu ʻana. Hiki i ka Birdshot Chorioretinopathy ke alakaʻi i nā pilikia ma ka ʻaoʻao waena o ka retina, e like me ka cystoid macular edema a me nā membrane epiretinal.

Pehea e ʻike ʻia ai ke Chorioretinopathy o Birdshot?

Hiki i kekahi manawa ke paʻakikī iki ka ʻike ʻana i kēia maʻi no ka mea he maʻi laha ʻole ia a ʻaʻole ʻike ʻia nā kiko ʻokoʻa i nā pae mua o ka maʻi.

Hoʻomaʻamaʻa pinepine nā kauka maka i ka BSCR ma o ka hoʻokolokolo maka. Hana pū lākou i kahi hoʻāʻo koko e nānā inā loaʻa iā ʻoe ka antibody HLA-A29.

Hiki i nā kauka ke hoʻohana i nā ʻano hoʻokolohua like ʻole e nānā iā ʻoe i ka hala ʻana o ka manawa. He mea nui e hoʻomau i ka launa pū me kāu kauka e loaʻa ai ka mālama āu e pono ai.

Aia kekahi lāʻau lapaʻau piha no ka Birdshot Chorioretinopathy?

ʻO ka mea pōʻino, ʻaʻohe lāʻau lapaʻau piha no kēia maʻi. Eia nō naʻe, inā ʻike ʻia a mālama ʻia ka maʻi i ka wā mua , hiki ke hoʻēmi ʻia nā hōʻailona a hiki ke pale ʻia ka maʻi mai ka ʻino ʻana.

E hoʻomanaʻo: ʻo ka mea nui loa, ʻo ia ka ʻike mua ʻana i ka maʻi a hoʻomaka i ka mālama ʻana!

ʻO wai ka mea hiki ke komo i kaʻu hui lapaʻau?

E paipai kāu hui mālama i nā lāʻau lapaʻau, e nānā iā ʻoe, a e hoʻoponopono i kāu mau lāʻau lapaʻau e pili ana i kou kūlana a me nā hopena ʻaoʻao. Hiki i kāu hui ke komo pū me:

• Kauka maka : ʻO ke kauka nui e mālama ana i nā maka.
• Kauka Nephrologist : No ka mea, pili kekahi mau lāʻau lapaʻau i nā puʻupaʻa.
• ʻO ka immunologist ocular: He kauka i loaʻa ka hoʻomaʻamaʻa kūikawā i nā pilikia o ka ʻōnaehana pale o ka maka.
• Rheumatologist: He kauka loea i nā maʻi e pili ana i ka mumū i loko o ke kino, no ka mea, he maʻi kēia o ka mumū.
• Orthopedist : No ka mea, pili kekahi mau lāʻau i nā iwi.

Pehea e mālama ʻia ai ka Birdshot Chorioretinopathy?

ʻO ka mālama ʻana no kēia maʻi e pili ana i ke koʻikoʻi o kou kūlana a pehea e loli ai i ka hala ʻana o ka manawa. ʻO ka pahuhopu nui o ka mālama ʻana, ʻo ia ka hōʻemi ʻana i ka pehu ʻana i kou mau maka a pale a hoʻihoʻi paha i kekahi o ka ʻike i nalowale .

ʻO ka maʻamau, kuhikuhi mua nā kauka i nā lāʻau corticosteroids kiʻekiʻe (kahi ʻano lāʻau steroid) e kāohi i ka pehu ʻana o nā maka. A laila, hoʻemi mālie ʻia ka nui e hōʻemi i ka pilikia o nā hopena ʻaoʻao. Hiki iā ʻoe ke loaʻa nā steroids ma nā ʻano penei:

• Nā kulu maka
• Nā lāʻau lapaʻau waha
• He mea liʻiliʻi i hoʻokomo ʻia i loko o ka maka ma ke ʻoki kino (intravitreal implant)
• Hoʻokomo
• Hāʻawi ʻia i loko o kahi aʻa (IV - intravenously)

Pono hoʻi ka poʻe he nui e lawe i nā immunosuppressants no ka wā lōʻihi . Hoʻōki kēia mau lāʻau lapaʻau i kāu ʻōnaehana pale mai ka hoʻouka ʻana i kou mau maka. Hiki ke hoʻohana ʻia kekahi a ʻoi aku paha o kēia mau mea:

• `(Nā mea hoʻohuihui)`
• `(Nā lāʻau lapaʻau Antimetabolite)`
• `(Nā mea olaola)` (nā lāʻau lapaʻau olaola)
• `(Nā mea pale i ka hoʻoili ʻana o nā pūnaewele T/calcineurin)`

Hiki i nā lāʻau lapaʻau ʻo Birdshot Chorioretinopathy (Birdshot Chorioretinopathy) ke hana i nā hopena ʻaoʻao?

ʻAe, ʻo ka hoʻohana lōʻihi ʻana i nā steroids a me nā immunosuppressants hiki ke hana i nā hopena ʻaoʻao koʻikoʻi . No ka laʻana, hiki ke loaʻa nā pilikia gastrointestinal (nā ʻōpū, nā ʻōpū) a i ʻole nā ​​​​pilikia iwi (osteoporosis). Hiki i kēia mau lāʻau lapaʻau ke hoʻonui i ka pilikia o ka hoʻomohala ʻana i nā cataracts a i ʻole glaucoma.

E nānā kāu kauka iā ʻoe no nā hopena ʻaoʻao a kuhikuhi i nā lāʻau lapaʻau ʻē aʻe inā pono. Inā ʻoe e lawe ana i nā steroids waha, e nānā kāu kauka iā ʻoe no ka nalowale o ka iwi (osteoporosis) a me kou pilikia o ka haki ʻana.

ʻO kāu kaukaHiki ke ʻōlelo ʻia kekahi e nānā i ka nui o ka iwi. Hiki ke kuhikuhi ʻia nā lāʻau lapaʻau (bisphosphonates) e pale aku i ka nalowale o ka iwi.

He aha ke ʻano o ka nānā ʻana i ka wā lōʻihi e pono ai iaʻu no (BSCR)?

E makaʻala i nā loli a i ʻole nā ​​pilikia i kou kūlana. E hana kāu kauka i nā hoʻāʻo koko a me ka mimi e nānā i ka hana maikaʻi o kou mau puʻupaʻa, akepaʻa, a me ka iwi iwi. Pono nō hoʻi ʻoe i nā hoʻokolohua maka maʻamau, nā hoʻokolohua kahua ʻike, a me nā scan optical coherence tomography (OCT).

Hiki iaʻu ke hōʻemi i koʻu pilikia o ka loaʻa ʻana o ka Birdshot Chorioretinopathy?

ʻAʻohe ala i ʻike ʻia e pale aku ai i kēia maʻi i kēia manawa . I ka hapanui o nā hihia, ua manaʻo ʻia ua hoʻokumu ʻia e kahi gene antibody kikoʻī (antigen) i hoʻoilina ʻia mai nā lālā o ka ʻohana.

Hiki i nā hoʻokolohua maka maʻamau ke kōkua i ka ʻike ʻana i nā hōʻailona mua o ka maʻi, i hiki iā ʻoe ke loaʻa ka lāʻau lapaʻau i ka manawa kūpono inā pono. E haʻi i kāu kauka inā loaʻa i kekahi o kou ʻohana nā pilikia maka.

He aha ka manaʻo no ka Birdshot Chorioretinopathy?

ʻOkoʻa ke ʻano o kēia maʻi mai kēlā kanaka a kēia kanaka . Aia ia i ke koʻikoʻi o ke kūlana a me ka holomua o ka mālama ʻana. I nā hihia palupalu, hiki i ka mālama ʻana ke kōkua i ka mālama ʻana a i ʻole ka hoʻomaikaʻi ʻana i ka ʻike.

Āhea wau e ʻimi ai i ke kōkua lapaʻau no (Birdshot Chorioretinopathy)?

He mea nui e ʻimi koke i ka ʻike a me ka lāʻau lapaʻau mai kahi kauka maka no Birdshot Chorioretinopathy. ʻOiai inā maikaʻi kou ʻike, hiki i ka hoʻokolokolo maka ke ʻike i ka pehu haʻahaʻa.

E haʻi i kāu kauka e pili ana i nā hopena ʻaoʻao, nā loli i nā hōʻailona, ​​a i ʻole ka ʻike ʻana mai kāu lāʻau lapaʻau. Hiki ke hāʻawi ʻia iā ʻoe kekahi lāʻau lapaʻau ʻē aʻe inā pono. E kamaʻilio kāu kauka me ʻoe e pili ana i nā koho i kūpono loa iā ʻoe.

Leka Hoʻihoʻi Hope Loa

He maʻi laha ʻole ka (Birdshot Chorioretinopathy) akā hiki ke mālama ʻia . No laila, mai hopohopo. ʻO ka mea nui loa, ʻo ia ke nānā mau i kou mau maka a hahai i nā ʻōlelo a kāu kauka . I ka hala ʻana o ka manawa, e haʻi aku kāu kauka iā ʻoe pehea e pale ai i kou ʻike a pale i nā pilikia. A laila e hiki iā ʻoe ke ʻike maopopo i ke ao nei no ka manawa lōʻihi. E mālama i kou mau maka, no ka mea, he mea waiwai nui lākou!

ʻO Birdshot Chorioretinopathy, Nā Maʻi Maka, Ka Pōʻino o ka ʻIke, Uveitis, Retina, Nā Maʻi Autoimmune, Lapaʻau Maka